Short answer: Agents can obtain official SBC templates and instructions from federal agencies, and plan-specific SBCs from insurance carriers or third-party administrators.
Agents who need a Summary of Benefits and Coverage (SBC) template or sample have several reliable sources, depending on whether they are looking for a blank template or a plan-specific document.
Federal agencies publish the official SBC templates and instructions. The Centers for Medicare & Medicaid Services and the U.S. Department of Labor provide standardized SBC templates, detailed preparation instructions, coverage example calculators, and the required uniform glossary of coverage terms. These materials are updated periodically and are intended to ensure SBCs meet federal formatting and content requirements.
For actual health plans, SBCs are typically prepared by the insurance carrier for fully insured plans or by the third-party administrator for self-funded plans. Agents can request the most current plan-specific SBCs directly from these sources to share with employers and employees.
Using official templates and carrier- or TPA-prepared SBCs helps ensure the document complies with federal rules and reflects the correct plan terms.
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, SBC Templates and Instructions
https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/sbc-template
Content history
Originally published: June 16, 2025
Last reviewed: January 25, 2026