Short answer: SBCs must be provided in non-English languages when federal thresholds are met, and a notice of language availability must be included if at least 10% of a county’s population is literate only in the same non-English language.
Although Summary of Benefits and Coverage (SBC) documents are generally provided in English, federal rules require additional language accommodations in certain circumstances.
If a group health plan is offered in a U.S. county where at least 10% of the population is literate only in the same non-English language, the SBC must include a prominent notice in that language explaining the availability of language assistance. In these counties, a translated version of the SBC must be provided upon request.
The determination of whether a county meets this threshold is based on U.S. Census data and is updated periodically by federal agencies. Common languages that frequently trigger these requirements include Spanish, Chinese, Tagalog, and Navajo, depending on the geographic area.
Federal agencies provide translated SBC templates and model language notices to assist with compliance. Employers and insurers are responsible for reviewing the applicable county language thresholds to determine whether translation and notice requirements apply.
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 -
U.S. Department of Labor, Culturally and Linguistically Appropriate Services for SBCs
https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-template -
29 CFR §2590.715-2715
Content history
Originally published: June 16, 2025
Last reviewed: January 25, 2026