Complying with Final Regulations on Cost Transparency for Group Health Plans and Insurers

Worldwide Employee Benefits Network [WEB] - New York Chapter

Are you up on the November 2020 DOL, HHS and Treasury final regulations that implement the Affordable Care Act’s cost-transparency requirements for group health plans and health insurers?  Join us to hear Ashley Gillihan of Alston & Bird cover all you need to know to effectively comply with these specific regulatory requirements within the very short time frames established by the agencies.   The final regulations have two main components: 

1. A publicly accessible website that identifies the plan’s cost for all in-network and out of network covered services as well as covered prescription drugs in machine readable files
2. A self-service tool for participants and beneficiaries to determine their estimated cost sharing liability with respect to covered in-network, out of network and prescription drug services and supplies 

In this session we will answer the following questions and more:

• • What information is specifically required to be made available to the public?  
• • What information is specifically required to be made available to participants and beneficiaries?
• • In what format must the information be? 
• • If a plan is fully insured, can the employer transfer liability to the carrier?
• • If the plan is fully insured, can the employer transfer liability to the third-party administrator?
• • What is the liability for failing to comply?
• • How will plans get this done in time?

The program will also address the transparency-related provisions in the Consolidated Appropriations Act.  

Featured Speaker:  Ashley Gillihan, Partner, Alston & Bird LLP 

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