Departments Issue Interim Final Rule on Group Health Plan Cost and Pricing Disclosure - Bim Group

Departments Issue Interim Final Rule on Group Health Plan Cost and Pricing Disclosure

READ TIME: 5 MINUTES

On November 17, 2021, the Internal Revenue Service (IRS), U.S. Department of Labor (DOL) and Health and Human Services (HHS) (collectively, the “Departments”), with the Office of Personnel Management (OPM), issued interim final regulations (IFR) to provide guidance regarding health care transparency provisions of the Consolidated Appropriations Act, 2021 (CAA). The IFR will apply to group health plans effective December 27, 2021. However, the Departments have announced a non-enforcement policy for the first year of applicability.

In late 2020, Congress enacted the CAA, which added general transparency obligations on group health plans regarding accuracy of provider directories, information to be placed on insurance ID cards and requirements to ensure continuity of patient care when a provider switches from in-network to out-of-network during a course of treatment. The CAA also contained provisions targeting disclosure of plan pricing and cost information including specific requirements regarding prescription drug costs. The IFR specifically addresses plan obligation to report this information annually to the Departments.

Download the full advisor to learn what to report, who must report, and when reports Departments are due.

 

Recent Insights

November 19, 2021
News

Departments Issue Interim Final Rule on Group Health Plan Cost and Pricing Disclosure

READ TIME: 5 MINUTES On November 17, 2021, the Internal Revenue Service (IRS), U.S. Department of Labor (DOL) and Health and Human Services (HHS) (collectively, the “Departments”), with the Office of Personnel Management (OPM), issued interim final regulations (IFR) to provide guidance regarding health care transparency provisions of the Consolidated Appropriations Act, 2021 (CAA). The […]
Read more
November 19, 2021
News

Internal Revenue Service Issues Tax Inflation Adjustments for 2022

The Internal Revenue Service (IRS) issued Revenue Procedure 2021-45, which announces the annual inflation adjustments for tax year 2022. The revenue procedure provides adjustments for more than 60 tax provisions, including health flexible spending accounts under cafeteria plans and qualified small employer health reimbursement arrangements. For health flexible spending arrangement contributions, the dollar limitation on voluntary […]
Read more
November 16, 2021
News

HR Elements | Grief: The Underbelly of Change

READ TIME: 3 MINUTES A big raise, a colleague relocating to a different office, and training on a new client onboarding system… all three of these items have one thing in common: change. Initial reactions run the gamut. A big raise may mean you rally the troops for a celebratory happy hour, while losing an […]
Read more
November 16, 2021
News

Federal Requirements for Fully Insured and Self-Funded Plans

A plan sponsor’s requirements under federal law will vary depending on factors such as group health plan design, size, grandfathered status, and whether the plan is fully insured or self-funded. The lists HERE highlight the main federal requirements that apply when a plan is fully insured and when a plan is self-funded.       […]
Read more