Back on July 1, 2022, the Transparency in Coverage (TiC) Rules required that non-grandfathered health plans post information on a public website regarding in-network rates and out-of-network allowed amounts and billed charges for covered items and services.The data is contained in machine-readable files (MRF) that participants would have difficulty deciphering. Starting on January 1, 2023, plans must also provide a tool designed to help plan participants understand their actual costs for the 500 most common items and services. This requirement expands to apply to all covered items and services on January 1, 2024.Employers have been concerned about the requirement to post a link to the machine-readable files on their websites, since the information:
- Does not relate to their business
- Is not currently intended to be understood by individuals who may wish to review it.
Employers have been advised that it was necessary to post such a link based upon the language in the regulations. The regulations state that while a plan sponsor may contract with a third party to post the required files, if a plan chooses not to host the file on its own website, “it must provide a link on its own public website to the location where the file is made publicly available.”New FAQs which were issued on August 19, 2022, clarify that the Departments will interpret this requirement more liberally. Specifically, the FAQs provide that if a plan sponsor has delegated responsibility to a third party for the machine-readable file requirement, the plan sponsor DOES NOT have to post a link to those files on the website for their business. Instead, the guidance interprets that the requirement for the plan sponsor to post a link to the files only applies if the plan sponsor maintains a public website for the health plan itself. The guidance also clarifies that plan sponsors are not required to create a public website for their health plan merely to post these links.
