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Health Insurance FAQs

questions and answers about health insurance and employee benefits

Are SBCs required for dental and vision plans?

June 16, 2025January 25, 2026

Short answer: No. SBCs are generally required only for major medical coverage and do not apply to stand-alone dental or vision plans.


Summary of Benefits and Coverage (SBC) requirements apply to group health plans that provide major medical coverage. They do not apply to certain “excepted benefits,” which include most stand-alone dental and vision plans.

Dental and vision benefits are treated as excepted benefits when they are offered under a separate insurance policy, certificate, or contract and are not integrated with the employer’s major medical plan. When structured this way, SBC requirements do not apply.

However, if dental or vision benefits are bundled with a group health plan—meaning they are not offered under a separate policy or are integrated into the medical plan—SBC requirements may apply as part of the overall group health coverage. In those cases, the dental or vision benefits would be reflected within the SBC for the group health plan.

Whether SBC requirements apply depends on how the benefits are structured and administered, not simply on whether the coverage is labeled as dental or vision.

Sources

  • 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, Excepted Benefits
    https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/excepted-benefits

  • 29 CFR §2590.715-2715


Content history

Originally published: June 16, 2025
Last reviewed: January 25, 2026

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About SBCs

SBCs are standardized documents that clearly outline the benefits and coverage of health insurance plans. They are designed to help consumers understand and compare different health plans.

For small group agents, SBCs are important tools for explaining plan details and assisting employers and employees in making informed health insurance decisions.

Employers are required to provide eligible employees with an SBC for each plan offered at initial enrollment and at renewal time each year.


More SBC FAQs

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