What employers need to know about the upcoming Transparency in Coverage deadline and beyond.
You may have heard about a little thing called the Transparency in Coverage rule, which outlines rolling effective dates and requirements for health plans—specifically, mandates around making cost of coverage information publicly available, by when, and in what format. Here are the three key deadlines to know:
- July 1: Health plans are required to publish machine-readable files for plan costs in a publicly available place.
- Jan. 1, 2023: Plans must provide a self-service provider-finder tool for the 500 most shoppable health care services.
- Jan. 1, 2024: All health care services must be available on a self-service provider-finder tool.
That July 1 deadline is less than two months away. Businessolver recently surveyed our clients to understand how they’re planning to meet this requirement; most are opting to have their carrier host the machine-readable files, which is fully compliant with the rule.
However, employers should consider how these machine-readable files and the future deadlines for the Transparency in Coverage rule will affect employees’ benefits engagement.
Why HR teams should care about how their machine-readable files are hosted
The key phrase here is that these files are “machine readable,” not “human readable,” and that distinction could have hefty implications for the future self-service tool deadlines based on the complexity of a health plan.
Depending on how employers choose to host their files (with their carrier, with a third-party platform like Benefitsolver™, or by themselves) could affect the complexities of implementing the self-service tool mandates for 2023 and 2024. Where employers choose to host their files will affect employees’ benefits literacy and ease of access when it comes to shopping for quality, low-cost providers.
How HR teams can prepare for the self-service tool deadlines
Employers should consider looking beyond the basic “meets the minimum compliance standard” options that carriers offer and engaging tools and services that aim for compliance and user experience for the Jan. 1, 2023, deadline.
Employers opting for a carrier to host machine-readable files will have approximately one self-service tool for every plan type they offer. However, employers opting for a third-party service, or those that choose to host these files in-house, can simplify the experience (and help reduce employee benefits confusion) by housing all the data in one self-service tool.
Here’s what HR teams should consider ahead of the self-service tool deadlines:
- What does the user experience look like in the self-service tool employers are considering?
- How many of those tools will employees have to navigate through to find the right care and can employers/service providers simplify it into a single tool?
- How will employees receive communications about the self-service tool and its benefits?
For insight into those answers and more, watch our latest Brews with Bruce episode, featuring Sherri Bockhorst, Businessolver’s Senior Vice President of Innovation and Strategy.