This template is designed to provide a mechanism by which health plans can obtain values for the three coverage examples on page 5 of the Summary of Benefits and Coverage (SBC) Coverage template provided by Centers for Medicare and Medicaid Services (CMS), by electronically sending the 140 parameter values required by the Excel-based SBC coverage example calculator to the DLL. This allows for an automated calculation of the benefit scenario costs detailed on page 5 of the SBC. Returned values can then be saved to a text file, database, or mail merge document, for further use.
This calculator matches the data and logic used in the April 2017 version of the CMS Excel-based coverage example calculator.
The licensing fee for the DLL is $250.00, payable through the PayPal link below. This licensing requires one license for every physical machine the tool is installed on. The DLL license term is three years. Support for the DLL is available through (a) Technical Documentation page on this website; (b) Calculation Examples page on this website; and (c) email support via firstname.lastname@example.org.
Once your payment is received, we will email the installation packages for both the 32-bit and 64-bit versions of the DLL to the PayPal email address used for payment.
The values enclosed in the red rectangles in the illustration below (this is page 5 of the SBC) are the values that are calculated and returned by the SBCCovgCalc DLL.
The parameter values for the DLL correspond to the input values required on the BENEFIT_DESIGN tab of the CMS Excel coverage calculator:
The outputs from the SBCCovgCalc DLL correspond to the outputs on the RESULTS_SUMMARY tab of the CMS Excel calculator: