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Rules for QHP Transparency Soon Will Apply to Employers
HR Daily AdvisorLink to more items from this source
[Guidance Overview]
Aug. 19, 2015

"Insurers and plan sponsors soon will have to report to the government (and list on a web page) their policies on: out-of-network liability and balance billing; enrollee claim submission; claims and denials; recoupment of overpayments; medical necessity; prior authorization; drug exception timeframes; explanations of benefits; and coordination of benefits.... Although the QHP requirements take effect for 2016 policies, very similar rules soon (after an official rulemaking process) will apply to employer plan sponsors and group policy issuers selling outside of exchanges."

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