Session Discussion
The Consolidated Appropriations Act (“CAA”) represents the most significant push for transparency in employer-sponsored health plans since the Affordable Care Act (ACA). The law, which incorporates the No Surprises Act and Transparency in Coverage (TiC) rules, mandates sweeping changes on employer-sponsored health plans, forcing the disclosure of previously hidden cost and quality information. Plan sponsors now face an actively enforced compliance calendar that includes the Gag Clause Prohibition Compliance Attestation (“GCPCA”), detailed Prescription Drug Data Collection (“RxDC”) reporting, and full deployment of a member Price Comparison Tool for all covered services. Looking ahead, employers should monitor the status of the deferred Advanced Explanation of Benefits (AEOB) and Good Faith Estimate (GFE) process.
The primary focus for plan sponsors is now mitigating ERISA fiduciary risk by mastering CAA requirements and clearly defining the compliance boundaries of their service providers (Third-Party Administrators, carriers, etc.) Plan Sponsors should implement a proactive monitoring strategy to ensure these complex compliance functions are properly being executed.
Key Topics
- High level review of the 2021 Consolidated Appropriations Act (“CAA”).
- Identify and explain the actively enforced CAA requirements for group health plans (including the Gag Clause Prohibition Attestation, RxDC Reporting, and Price Comparison Tool).
- Identify and explain the actively enforced CAA requirements (including the Gag Clause Prohibition Attestation, RxDC Reporting, and Price Comparison Tool).
- Evaluate Service Provider Responsibilities: Working with their trusted advisor, plan sponsors should be able to identify and analyze the shared compliance burden with service providers and establish contractual protections (e.g., indemnification, audit rights) to mitigate the plan sponsor’s ERISA fiduciary risk.
- Develop a Proactive Monitoring Strategy: Plan sponsors should continue monitoring CAA guidance and future effective dates (particularly for deferred mandates), working closely with their trusted advisor and legal counsel, to ensure internal stakeholders are prepared to meet the law’s ultimate transparency goals.
Moderator and Guest Speakers
The webinar will feature insights from industry leaders across engineering, legal, and risk management disciplines:
- Speakers:
- Paul Van Brunt
- Deanna Sizemore
- Moderator:
- Marie Smith
For more information
We’re ready when you are. Get in touch and a friendly, knowledgeable Baldwin advisor is prepared to discuss your business or individual needs, ask a few questions to get the full picture, and make a plan to follow up.
This webinar is intended for general information purposes only and should not be construed as advice or opinions on any specific facts or circumstances. The content of this webinar is made available on an “as is” basis, without warranty of any kind. The Baldwin Insurance Group Holdings, LLC (“The Baldwin Group”), its affiliates, and subsidiaries do not guarantee that this information is, or can be relied on for, compliance with any law or regulation, assurance against preventable losses, or freedom from legal liability. This publication is not intended to be legal, underwriting, or any other type of professional advice. The Baldwin Group does not guarantee any particular outcome and makes no commitment to update any information herein or remove any items that are no longer accurate or complete. Furthermore, The Baldwin Group does not assume any liability to any person or organization for loss or damage caused by or resulting from any reliance placed on that content. Persons requiring advice should always consult an independent adviser.
