What is the purpose of a "summary of benefits and coverage" (SBC)?

The purpose of a "summary of benefits and coverage" (SBC) is to provide clear and concise information about a health plan’s coverage, including what is included and excluded in the plan, as well as costs associated with services and treatments. This document is essential for helping consumers understand their healthcare options, making it easier to compare different health plans and choose the one that best suits their needs. The SBC outlines key features such as deductibles, copayments, and coverage limits in straightforward language, ensuring that individuals can make informed decisions regarding their health insurance.

The other options do not align with the primary function of an SBC. It does not address the investigation of fraud, the automated calculation of premiums, or any approval processes related to applications. Instead, the SBC serves as a transparent resource for policyholders and potential customers to grasp the essentials of their health coverage effectively.