The July 1st deadline is quickly approaching for non-grandfathered group health plans and issuers to publicly disclose, in accordance with the Transparency in Coverage Final Rules, price information in machine-readable files for the plan year beginning on or after January 1, 2022. The two machine-readable files must show (1) in-network negotiated provider rates for covered items and services and (2) out-of-network allowed amounts and billed charges for covered items and services.
Group health plans and issuers are required to post the machine-readable files on a publicly available website that is accessible to any person free of charge and without conditions (i.e., free of any requirements to establish a user account, password, or other credentials). The files must be updated on a monthly basis.
Issuers and group health plans may either host the machine-readable files on their own website or include a link on their own website to a third-party website that is hosting the files. For example, if the machine-readable files are hosted on a website by an issuer or third-party administrator, a group health plan will satisfy the public disclosure requirement by including a link to the insurer’s or third-party’s website on the plan sponsor’s (e.g., employer’s) public website or on a public website that is branded for the group health plan. The link may be posted on any existing webpage on an employer’s website, such as a webpage for securities filings or job postings, as long as the webpage clearly identifies the link to the group health plan’s machine-readable files and is accessible to the public without conditions.
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