Departments Issue Transparency in Coverage Rule
New Rule Requires Disclosure of Cost-sharing Information
On Oct. 29, 2020, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued a final rule regarding transparency in coverage that imposes new transparency requirements on group health plans and health insurers in the individual and group markets.
The final rule requires plans and issuers to disclose:
Cost-sharing estimates to participants, beneficiaries and enrollees through an internet-based self-service tool, beginning with the 2023 plan year; and
In-network provider-negotiated rates and historical out-of-network allowed amounts on their public website, for plan years beginning on or after Jan. 1, 2022.
These provisions only apply to non-grandfathered coverage, including both insured and self-insured group health plan sponsors.