Short answer: SBCs must be provided at initial enrollment, during open enrollment, upon request, and in advance of certain mid-year plan changes.
Employers or insurers are required to provide a Summary of Benefits and Coverage (SBC) at specific times so employees can understand their coverage and compare options before making enrollment decisions.
An SBC must be provided when an employee first becomes eligible for coverage, such as at initial hire. It must also be provided during open enrollment or any other enrollment period when employees are allowed to choose or change health plans. Even if plan terms remain unchanged, SBCs are still required at renewal.
Employees and beneficiaries are also entitled to receive an SBC upon request. In those cases, the SBC must be provided as soon as practicable, but no later than seven business days after the request is made.
If a health plan makes a material modification outside of the regular renewal period that affects information in the SBC, an updated SBC must be provided at least 30 days before the change takes effect. This advance notice requirement applies only to changes that occur mid-year and materially alter plan terms reflected in the SBC.
These timing rules are intended to ensure employees have sufficient opportunity to review plan information and make informed decisions about their health coverage.
Sources
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Centers for Medicare & Medicaid Services, Summary of Benefits and Coverage (SBC)
https://www.cms.gov/cciio/resources/forms-reports-and-other-resources/summary-of-benefits-and-coverage -
Affordable Care Act, Section 2715
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29 CFR §2590.715-2715
Content history
Originally published: June 16, 2025
Last reviewed: January 25, 2026