Exhibit 4: Sample Contact Information for More Details about Coverage 3. All these services and costs seem to be adding up quickly! Does this plan offer any protection for me if I have to pay a lot out-of-pocket in one coverage year? To answer this question, return to page 1, shown in Exhibit 2, and find the row for “What is the out-of-pocket limit for this plan?” The out-of-pocket limit, as explained in the Uniform Glossary, is the most Ella could pay during a policy period (usually a year) before her health insurance company begins to pay 100 percent of the allowed amount. In this example, if Ella spends over $2,500 for services from in-network (or participating) providers, the health insurance company will begin to pay 100 percent of the allowed amount. As this plan’s SBC shows, the out-of-pocket limit never includes premiums, balance-billed charges1, or health care the health insurance company doesn’t cover. Additionally, some health insurance companies don’t count all copayments, deductibles, coinsurance payments, out-of-network payments, or other expenses toward this limit. 4. Thanks! Now that I know how to interpret the cost sharing features of a plan using the SBC, maybe I should look at another SBC to see how this plan matches up to another plan I was considering earlier. Tell Ella that using the SBC to make apples-to-apples comparisons easier is exactly one of the main purposes of the SBC. If she doesn’t have ready access to the other SBC, she can always request it from the insurance company, which must send it within seven business days. Additional Resources For more information visit:  CMS: Summary of Benefits and Coverage Available at: http://www.cms.gov/CCIIO/Programs-and-Initiatives/Consumer-Support- and-Information/Summary-of-Benefits-and-Coverage-and-Uniform-Glossary.html 1 For a definition of balance billing, go to: https://www.healthcare.gov/sbc-glossary/#balance-billing.