The Department of Labor, Health and Human Services and the Department of Treasury recently passed a new law to promote transparency in health care coverage. Starting with plan years beginning on or after Jan. 1, 2023, group health plans and health insurance carriers must make an internet-based price comparison tool available to participants, beneficiaries and enrollees. Keep reading to learn more about what this law means for you.
This tool’s purpose is to provide consumers with real-time estimates of their cost-sharing liability from different providers for covered items and services. This gives them the opportunity to shop and compare prices before receiving care.
This requirement applies to health insurance issuers and group health plans, including fully insured and self-insured plans. It does not apply to grandfathered plans, excepted benefits and account-based plans, such as health flexible spending accounts and health reimbursement arrangements.
For plan years beginning in 2023, the price comparison tool must provide cost-sharing information for 500 items and services. Beginning in 2024, the tool must provide cost-sharing information for all covered items and services.
Most employers will rely on their issuers and third-party administrators to provide this tool. Employers should confirm that their issuers and TPAs are in compliance by the deadline and ensure written agreements are updated to reflect this responsibility.
For more information about next year’s price comparison tool and how it affects your employees, contact CanopyNation today.