Extract summaries of benefits to structured JSON
Summary of Benefits and Coverage (SBC) documents standardize how health plans present coverage details. While federally mandated, carrier implementations vary in layout and terminology. Sensible extracts SBC data into validated JSON for plan comparison, benefits administration, and enrollment.
Why SBC documents need specialized extraction
Despite a standardized template, carriers vary in visual layout, table structure, and category labels.
SBCs list cost-sharing for dozens of service categories. Sensible extracts each line with copay, coinsurance, and deductibles.
Every service has separate in-network and out-of-network costs. Sensible extracts both and maps them to the correct category.
SBCs describe excluded services and coverage limitations in text. Sensible extracts these as structured lists for comparison.
Fields we extract
Extract any data you need from SBCs into your desired output schema
Plan name, plan type (HMO/PPO/EPO/POS), coverage period, deductible (individual/family), out-of-pocket maximum, copay/coinsurance structure
Service category, in-network cost sharing, out-of-network cost sharing, deductible applies (yes/no), prior authorization required, visit limits
Excluded services list, coverage limitations, pre-existing condition rules, prescription formulary tier structure
Summary of vision coverage including exam, frames, and lens benefits.
Summary of dental coverage including preventive, basic, and major services.
SBC for individual marketplace health insurance plans.
Summary of Benefits and Coverage for employer-sponsored group health plans.
Supported SBC formats
Sensible processes SBCs from any health plan or carrier. No template needed. Any new SBC layout can be configured to your plan comparison schema in hours.
Group health plans (employer-sponsored), individual marketplace plans (ACA), Medicare Advantage, dental, vision
UnitedHealthcare, Anthem, Aetna, Cigna, Humana, BCBS affiliates, Kaiser, regional health plans
Common Questions
Specific details about our SBC data extraction engine.
Yes. Sensible outputs SBC data in a consistent schema. You can compare copays, deductibles, out-of-pocket maximums, and covered services across plans programmatically.
Sensible captures deductibles, copays, coinsurance, out-of-pocket maximums, and coverage percentages for both in-network and out-of-network services.
Yes. Sensible extracts the cost-sharing structure for each covered service category including primary care visits, specialist visits, emergency room, hospitalization, prescription drugs, and more.
Yes. Sensible sends extraction results to your webhook endpoint when processing completes. You can also poll the API for status.
Yes. Sensible flags extractions with low confidence for human review. You can configure review thresholds and workflows.
Sensible is SOC 2 Type II certified and HIPAA compliant. Data is encrypted in transit and at rest.
Documents are deleted after 30 days by default. You can configure shorter retention periods or request immediate deletion via API.
Yes. Sensible offers a free tier with 50 documents per month. No credit card required to start.
Sensible uses per-document pricing for predictable costs. No token-based billing or usage surprises. Volume discounts are available for higher throughput.
Sensible provides REST APIs and SDKs for Python and Node.js. Most integrations take a few hours. Webhooks, Zapier, and direct API calls are all supported.
Sensible processes PDF, PNG, JPG, and TIFF files. PDFs can be native or scanned.
Accuracy depends on document quality and configuration. Most production deployments achieve 95%+ accuracy with proper validation rules and confidence scoring.
Most documents process in 2 to 10 seconds depending on complexity and page count.