Guidelines & Disclosures
Consolidated Appropriations Act
No Surprises Act
Intended to protect consumers from some unpredicted medical bills after receiving care from out-of-network providers. This allows negotiation for reimbursement through an independent dispute resolution process.
Learn more: Federal Guideline
ID Card Requirements
Requires health plan IDs to include both in-network and out-of-network information about deductibles and out-of-pocket maximum limitations, as well as a phone number or website to obtain additional information.
Learn more: Federal Guideline
Advanced EOB
A database must be created that includes a list of providers and facilities that are in-network and must be verified and updated every 90 days.
Learn more: Federal Guideline
Mental Health Parity
Requires insurance coverage for mental health conditions, including substance use disorders, to be no more restrictive on coverage than any other medical condition.
Learn more: Federal Guideline
Provider Directory Requirements
A database must be created that includes a list of providers and facilities that are in-network and must be verified and updated every 90 days.
Learn more: Federal Guideline
Transparency in Coverage
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