On December 27, 2020 the Consolidated Appropriations Act(CAA) COVID-19 Relief bill was signed into law. This bill included many healthcare provisions including the Transparency in Coverage requirement. This requires Self-Funded/Level Funded health plans or issuers to publicly provide certain health care price information via Machine-Readable Files (MRF) on their own public websites effective July 1, 2022. The MRF will include such information as negotiated rates with in-network providers and allowed amounts for out-of-network providers. Reporting on Pharmacy Benefits and Costs will be also be required but is currently pending additional rule making. We are anticipating the compliance date for the Pharmacy Benefits requirement to be December 27, 2022. We at will update your organization as any additional information becomes available.
What are the requirements?
Employers sponsoring a self-funded/level-funded medical plan are required to post links/source date to those machine-readable files that contain the pricing information on a publicly available website to any person free of change and without conditions, such as establishing a user account, password, any other type of credentials, or submission of any personally identifiable information to access the file. This link must be on the front page of the company’s publicly facing website. The font size and color must be the consistent with rest of the webpage. The link should be on easily identified on the page and must be labeled “Transparency in Coverage”.
The source link for the Transparency in Coverage is: https://www.bluecrossnc.com/about-us/policies-and-best-practices/transparency-coverage-mrf# This is the source information that will connect back to the external site where the MRF is hosted and allow the file to be downloaded. Please be aware that this link many not be active until July 1, 2022.
Enforcement on this begins on July 1, 2022 with potential files of up to $ 100.00 per day for each violation and for each individual affected by the violation.
At the start of a new plan year, it’s especially important for you to present your new health insurance ID card each time you see a provider or fill a prescription. This ensures your claims process just as they should, according to your plan benefits.
We want to make sure you have access to your policy information, should your ID cards be delayed.
Fortunately, if you don’t have your ID card in-hand, you can access a digital ID card using the Blue Connect mobile app.
As a reminder, Blue Connect can help you with more than just a digital ID card – you can use it to track your claims and deductibles, search for providers, and so much more.
Attached is information that highlights benefits for the LIFE, Inc. Health Plan. Any questions or issues should be directed to the Plan Administrator (Wilson Raynor).
Retirement Plan Participant Information
Attached is a copy of the participant notice that provides details of the fee changes scheduled to go into effect on Friday, December 28, 2018 in the Retirement Plan. The first page explains the new rules if you would like to read. The second page is the fee amount for the Retirement Plan. This will save the Retirement Plan money compared to previous years.