What the “No Surprises Act” Means for You

Jan 15, 2022

Employer plan sponsors and health insurance issuers are responsible for notifying employees about their rights under the “No Surprises Act.” The act’s protection of employees went into effect, as of Jan. 1, 2022.

The No Surprises Act was passed under the Consolidated Appropriations Act of 2021. The act prohibits balanced billing when an individual seeks emergency care out-of-network or if a person receives care from an out-of-network provider at an in-network facility without giving their written consent.

There are certain requirements for employers’ disclosure of the No Surprises Act, which are met in this model notice (a copy of this model notice can be downloaded below).

Group health plan sponsors and health insurance carriers must distribute the disclosure in the following 3 ways: 

  1. Make the notice publicly available, AKA posting a copy of the model notice in a public location where they post other workplace notices. Best practice: Including the model notice in Open Enrollment materials and new-hire packets
  2. This disclosure must be publicly accessible to all employees, meaning it can be accessed without logging in or providing other credentials. Best practice: Group plan sponsors should make sure that their carrier or TPA can post the notice language on their plan website in an accessible manner. In addition, employers should consider posting a copy on any internal human resources websites.
  3. Each EOB notice sent by the plan also needs to include the notice language. Health insurance carriers should ensure the notice is part of their EOB mailings beginning with each group’s 2022 renewal. Groups with self-funded coverage need to verify that their TPA is prepared to include the notice language with all 2022 EOBs moving forward.
notice post

Related Posts

Pay Transparency

Pay transparency is rising on the list of employees’ demands, and employers should consider preparing to provide it. There are…

Amazon Debuts New Virtual Health Care Service

On Nov. 15, 2022, Amazon launched Amazon Clinic, an online telehealth service. The service connects individuals with medical professionals through…

PCORI Fee Amount Adjusted for 2023

The Internal Revenue Service (IRS) has issued Notice 2022- 59 to increase the Patient-Centered Outcomes Research Institute (PCORI) fee amount…

Scroll to Top