The Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued a final rule that imposes new health care transparency requirements on group health plans and health insurers in the individual and group markets.
Specifically, the final rule requires plans and issuers to disclose:
- Price and cost-sharing information to participants, beneficiaries and enrollees upon request:
- A list of 500 shoppable services must be available via the internet for plan years beginning or after Jan. 1, 2023.
- The remainder of all items and services is required to be available for plan years beginning on or after Jan. 1, 2024.
- In-network provider-negotiated rates and historical out-of-network allowed amounts on their website:
- Detailed pricing information must be made public for plan years beginning on or after Jan. 1, 2022.
The final rule also allows issuers 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.
We provide professional help designed to meet your specific needs with a wide range of insurance products for your business and your family. Learn more about our Benefit Analysts Insurance Products.
The content herein is provided for general information purposes only, and does not constitute legal, tax, or other advice or opinions on any matters. This information has been taken from sources which we believe to be reliable, but there is no guarantee as to its accuracy.