Editing the Plan overview tab
The Plan overview page of the SBC document contains the plan
high-level information such as overall deductible and out-of-pocket values. You edit the
information on the Plan overview tab so that it reflects the
information about your products or plans. Members use this section of the SBC document to understand some of the health plan’s
costs, including deductible amounts and out-of-pocket limits. This section also contains
information on coverage for different networks, based on the structure of your products
and plans. In the header, the product name or plan name, Coverage period, Coverage for, and Plan
Type fields are populated from your product or plan when you create the SBC documents
within your product or plan. By clicking on the blue hyperlinks, you are directed to a healthcare glossary of medical
terms. The following figure shows the Plan overview tab in an SBC template. If there is text in the cell of the Answers column, you can change
the default answer of Yes and edit the text or you might just edit
the text. For example, you might click this answer to modify it: Yes. See [insert direct link or URL to plan-specific provider
directory] or call 1-800 [insert number] for a list of network
providers. If the Answers column has no text in a cell, it means that the answer
is based on the calculation method of the deductible or
out-of-pocket maximum that you specified in the product or plan. For
example, you might want to change the answer content for the
following question: What is the overall deductible? To override default text in the SBC template to meet your business needs,
administrators can use the data transforms described in this section to extend rules that
are related to the Plan overview tab.Optional: Extending rules related to the Plan overview tab
Action Rule name Override values in the header on the Plan
overview tab, such as the disclaimer section
or the company name. InitializeOverviewDetailEXT Override the default text in the Important
Questions column on the Plan
overview tab.
InitializeDocDataForSBCQuestionsEXT Override the default text in the Answers
and Why this matters
columns on the Plan overview tab
based on whether the default answer is
Yes or No. InitializeDataForSBCAnsAndWhyThisMattersEXT For the What is the overall deductible?
question, override the default description in the
Why this matters column based on
the calculation method. SetDefaultWhyThisMatters_OverAllDeductible
EXT For the Are there services covered before you meet
your deductible? question, override the default
text in the WhyThisMatters column
based on whether the default answer is
Yes or No. SetDefaultWhyThisMatters_ServicesCoveredBeforeDeductible
EXT For the Are there other deductibles for specific
services question, override the default text in
the WhyThisMatters column based on
whether the default answer is Yes or
No. SetDefaultWhyThisMatters_OtherDeductibleServicesEXT For the What is the out-of-pocket limit for this
plan? question, override the default text in the
Why This Matters column, which is
based on the calculation method. SetDefaultWhyThisMatters_WhatIsOOPEXT For the What is not included in the out-of-pocket
limit? question, overrides the default text in
the WhyThisMatters column based on
whether the default answer is Yes or
No. SetDefaultWhyThisMatters_WhatIsNotInOOPEXT For the Will you pay less if you use a network
provider? question, override the default text in
the Answers and
WhyThisMatters columns based on
whether the default answer is Yes or
No. SetDefaultWhyThisMatters_PayLessInNetworkEXT
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