The Consolidated Appropriations Act (CAA), No Surprises Act (NSA), and the Transparency in Coverage Final Rule (TiC Final Rule) impose several new requirements on employer-sponsored group health plans. A list of the various rules is included in Section 1. This guide will focus on the portion of the new rules that we will refer to as the “Transparency Requirements.”
The goal of the Transparency Requirements is to make it easier to understand and access information about what medical services cost and what health plans pay for those services. Historically, it has been very difficult, if not impossible, to find out what most health care services will cost in advance. As the various Transparency Requirements begin to come into force over the next few years, access to much more detailed information regarding healthcare costs will help consumers and businesses become better buyers of healthcare services.
While the Transparency Requirements may seem overwhelming at times, employers will find that in most cases they will be relying on their insurance carriers, administrators, and other vendors to do most of the heavy lifting. This guide is designed to help employers understand their role and navigate their compliance responsibilities. The guide will be regularly updated as additional regulations and guidance is issued.