Skip to main content


         This documentation site is for previous versions. Visit our new documentation site for current releases.      
 

Summary of Benefits and Coverage template

Updated on January 26, 2021

The Summary of Benefits and Coverage (SBC) is a snapshot of a health plan’s costs, benefits, covered healthcare services, and other features that are important to consumers. An SBC also explains the unique features of health plans such as cost-sharing rules and includes significant limits and exceptions to coverage in easy-to-understand terms. This document helps users to compare health plans.

Pega Product Composer for Healthcare

The SBC is mandated by the Affordable Care Act (ACA) as a requirement for healthcare plans.

With Pega Product Composer for Healthcare, you can create templates that can be reused within your products or plans to create SBC documents for multiple products or plans. The template lets you merge specific fields, for example, benefit coverage with the corresponding copayment from a product or plan so that you create a Summary of Benefits and Coverage document that is specific to the product or plan.

Have a question? Get answers now.

Visit the Support Center to ask questions, engage in discussions, share ideas, and help others.

Did you find this content helpful?

Want to help us improve this content?

We'd prefer it if you saw us at our best.

Pega.com is not optimized for Internet Explorer. For the optimal experience, please use:

Close Deprecation Notice
Contact us