Transparency and No Surprises Act Obligations of Group Health Plans

On August 20, 2021, the DOL, IRS and HHS released FAQs regarding the implementation of other CAA provisions. This guidance provides temporary enforcement relief with respect to specific CAA provisions pending the issuance of regulatory guidance. Additionally, certain deadlines for CAA requirements have been adjusted to better align and coordinate with similar requirements under the TIC final rule.

However, group health plan sponsors should not delay in consulting with their carriers or administrative service providers regarding implementing these new requirements. Although plan sponsors are ultimately responsible for compliance, it is anticipated that most will rely heavily upon third-party administrators to timely satisfy these obligations. So, sponsors should keep these new mandates in mind when negotiating service agreements and vendor contracts for upcoming plan years. They should also budget for the additional costs of compliance. Of course, employers should engage counsel for legal advice regarding the specific application of these laws to their group health plans and/or for assistance with related vendor contract negotiations. 

This white paper, presented in chart format, attempts to provide a high-level overview of important compliance requirements and effective dates under the recent federal legislation. References are provided for regulatory guidance issued as of the publication date; additional implementing guidance is expected. Compliance considerations and action items for group health plans sponsors are also included.