Summary of Dental Benefits and Coverage Matrix (SDBC) SB 1008

California’s SB 1008 requires fully insured health plans and health insurance policies that provide dental benefits coverage in California to use a standardized form (called the Summary of Dental Benefits and Coverage Disclosure Matrix or SDBC) to report and disclose each plan’s dental benefits, such as cost-sharing, exclusion and examples of commonly used benefits. Like the ACA’s Summary of Benefits and Coverage requirement, which applies for medical plans, SB1008 requires insurers and employers to utilize SDBCs to assist eligible employees and individuals to help them understand and compare each dental plan.

For group plans, dental insurers subject to the requirement will complete SDBCs and provide the completed SDBCs to plan sponsors (generally, employers) for each dental plan. Insurers are required to provide the applicable SDBCs to the plan sponsors upon delivery of the policies and provide them at the same time the insurers provide other disclosure materials, including the applicable evidence of coverage. Then, plan sponsors are required to distribute SDBC copies to their eligible employees and other individuals prior to their enrollment, and other specified time indicated in the law.

A plan sponsor can provide a SDBC using one of the following methods:

• Mail
• Email (and notify the individual that a paper copy is available free of charge)
• Direct the individual to the insurer’s website for a copy of SDBC (and notify the individual the availability of a paper copy upon request)

Employers should discuss with their dental insurers the applicability of SDBC and distribute SDBC to their eligible employees and other individuals timely.

SB 1008: Chapter 933 »