The new year brings a host of new health care industry changes and regulatory compliance issues that will challenge employers–and they'll be looking to their broker partners to help them stay ahead of deadlines and keep abreast of new legislation. While many people are already looking ahead to the November elections and speculating about potential changes at the national and state levels, it's important not to be distracted by the unknowns when there are more immediate concerns on the horizon.
Brokers play a key role as trusted advisors to clients, helping them understand their compliance obligations by simplifying complex legislative changes and identifying action items. After all, it's not just new legislation that employers need to be aware of. Many existing rules and regulations have new requirements or phased implementations that change the expectations for employers over time.
New Transparency in Coverage Requirements
The Transparency in Coverage (TiC) rule was finalized in 2020, but featured a multi-year, phased implementation to give carriers and employers a roadmap for creating and launching self-service tools. The goal of the TiC is to enable health care plan participants to make informed choices about medical procedures and services. The prior phases of the TiC included requirements around accurate provider directories, prohibitions on balance billing, gag clause attestation, and more.
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