Crosswalk of Changes to Model Notices in the Summary of Benefits and Coverage PRA Package (CMS-10407)
The chart below outlines formatting inconsistencies in the public-facing SBC documents that were corrected to align with the formatting guidelines in the Summary of Benefits and Coverage Instruction Guide for Group1 and Individual2 Health Coverage.
SBC Document |
Pages affected |
Changes made |
Rationale for Change |
English Sample Completed SBC (Word) |
Page 4 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
English Sample Completed SBC Accessible Format (PDF) |
Pages 1, 4 and 5 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
English AIAN Limited Cost Sharing SBC (Word) |
Page 7 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
English AIAN Limited Cost Sharing SBC (PDF) |
Pages 1, 7 and 8 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
English AIAN Zero Cost Sharing SBC (Word) |
Page 5 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
English AIAN Zero Cost Sharing SBC (PDF) |
Pages 5 and 6 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
Chinese SBC Template Standard Format (Word) |
Pages 2, 4 and 5 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
Chinese SBC Template Accessible Format (PDF) |
Pages 2, 3, 4 and 5 |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
Chamorro SBC Template Standard Format (Word) |
All pages |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
Chamorro SBC Template Accessible Format (PDF) |
All pages |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
Navajo SBC Template Standard Format (Word) |
All pages |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
Navajo SBC Template Accessible Format (PDF) |
All pages |
Adjusted font size to 12-point |
To comply with SBC formatting requirements |
1 Summary of Benefits and Coverage: Instruction Guide for Group Health Insurance Coverage, available at https://www.cms.gov/files/document/group-instructions-060723.pdf.
2 Summary of Benefits and Coverage: Instruction Guide for Individual Health Insurance Coverage, available at https://www.cms.gov/files/document/individual-instructions-060723.pdf
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Khan, Mariam - EBSA |
| File Modified | 0000-00-00 |
| File Created | 2025-05-19 |