IMPORTANT: New Employer Requirements for Transparency in Coverage Effective July 1, 2022
This notice is for employee benefits clients with self-funded medical benefit plans. This includes all level-funded and most MEWA plans. Fully Insured clients do not need to do anything as the insurance carrier is required to comply.
The new requirement for certain employers is under the Consolidated Appropriations Act (CAA). It has several transparency requirements for providing health provider contracted rates as well as out-of-network allowances. The law requires that employers provide “Machine Readable Files” on a website that is publicly available by July 1, 2022. This data is in preparation for more member-friendly data to be provided later.
Luckily, most carriers and medical plan administrators have done the legwork by simply putting the information on their website with a database searchable by the employer’s tax identification number. That list of helpful carriers includes: Anthem MEWAs, Aetna Funding Advantage, Humana Level -Funded, and UnitedHealthcare Level-Funded.
Please refer to this table of carriers and medical plan administrators for a quick review of what we know as of the date of this article:
Carrier/Administrator |
Method of Compliance |
Carrier Notice Link |
Aetna Funding Advantage | Source provided on the Aetna website searchable by employer tax ID. | Letter sent to clients in early May |
AllState Level Funded | Source provided on the TPA’s website. Allied for the Cigna network or Meritain for the Aetna network. | Letter to clients will be sent soon. |
Anthem MEWAs
(SOCA, Ohio Farm Bureau, Kentucky Chamber, or Indiana Chamber) |
Source provided on the Anthem website searchable by employer tax ID. | Anthem Newsflash |
Humana Level Funded | Expected to have a website searchable by employer tax ID. | Humana issued a statement but no formal announcement has been made. |
MMO COSE MEWA | TBD | Intends to comply but no formal announcement as to how has been released as of this date. |
Paramount MEWA | TBD | |
Trustmark Level Funded | TBD | |
UHC Level Funded
(formerly called “AllSavers”) and the UHC Ohio Chamber MEWA |
Website with search by employer name:
www.transparency-in-coverage.uhc.com *See NOTE below. |
Notice sent to clients in late May. *See NOTE below. |
NOTE: UnitedHealthcare has notified customers they need to post this on an employer-specific public website, but we believe this will not be necessary given that UnitedHealthcare will have the information available on their own site, searchable by employer name.
If your administrator or carrier is not on the list and you are in a self-funded, level funded, or MEWA program, please contact your ARC client relations advisor for more information.