ID| The Idaho Department of Insurance issued Bulletin No. 25-04 on May 22, 2025, clarifying that health insurance carriers in Idaho may now use the federally required Summary of Benefits and Coverage (SBC), as established under the Affordable Care Act, to fulfill the state’s Outline of Coverage (OOC) requirement for disability/health insurance policies. This decision is based on the Department’s finding that the SBC provides information substantially similar to what is required by Idaho Code § 41-4205, and is effective immediately.
Key points:
- Idaho health insurance carriers can use the ACA-mandated SBC to meet the state’s OOC requirement for individual and group health plans.
- The Department determined that the SBC’s content and format are substantially similar to the OOC requirements under Idaho law.
- This guidance is effective immediately and is an interpretation of existing law, not a new law or regulation.