Transparency in Coverage Act: 3 things brokers need to know

Starting July 1, 2022, most group health plans and issuers of group or individual health began posting pricing information for covered items and services. Known as the Transparency in Coverage Act, this provision is intended to empower consumers with the necessary information to make better-informed decisions regarding their health care in three stages, starting with the July 1 enactment. The rule requires plans and issuers to make machine-readable files publicly available that will disclose in-network rates and out-of-network allowed amounts and billed charges for plan or policy years that start on or after January 1, 2022.

This act is one of several laws and regulations that have passed over the years, complementing the No Surprises Act and the Consolidated Appropriations Act of 2021 as ways to offer consumers more information about health care prices and to protect them from being overcharged. Employers and benefits advisors need to be proactively thinking about this change so they can set employees up for success. Some employers have stepped in to remedy this situation, implementing year-round communications campaigns focusing on employee benefits, offering one-on-one enrollment support, and providing employees with tools and services to help them navigate their health plans and benefits coverage.

Also: 5 predictions for employee benefits in 2022 and beyond