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services, out-of-pocket limit, network provider, referral, specialist, cost sharing application/pdf SBC Template Standard Format CMS Provides a fillable Summary of Benefits and Coverage template to provide answers to key questions and information about common medical events Microsoft® Word for Microsoft 365 2023-08-15T21:44:13-05:00 2023-10-10T14:33:08-05:00 2023-10-10T14:33:08-05:00 uuid:CC47F4FE-15E4-43A0-9A3F-8F36DA74F81E uuid:5d3bb822-9c08-1046-87f8-0213c8eae40f endstream endobj 2076 0 obj <> endobj 2077 0 obj <>stream HWko_OfS|shb'٤4^XŢ, YkҌW5KrY4iE.sG7yLs}O :<[FaF,ohn&I:ɓ,E]}F? 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