New transparency requirements on group health plans and health insurers in the individual and group markets were issued by the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments).
The final rule requires plans and issuers to disclose:
- Price and cost-sharing information for a list of 500 services must be available via the internet for plan years beginning Jan. 1, 2023. All items and services are required to be available for plan years beginning Jan. 1, 2024.
- In-network provider-negotiated rates and historical out-of-network allowed amounts on their website for plan years beginning Jan. 1, 2022.
The final rule also allows insurers that share savings with consumers—resulting from consumers shopping for lower-cost, higher-value services—to take credit for those “shared savings” payments in their medical loss ratio calculations.
Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services. We can customize a wellness plan for your budget and culture.