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Government mandates changes for health care

Late in 2020, the federal government enacted several health care mandates, many of which apply to health insurance. The implementation timeline is relatively short considering many regulations are still being finalized.

Current mandates fall into four categories:

  • Consolidated Appropriations Act—aka No Surprise Billing
  • Price Transparency—clear accessible pricing information
  • Interoperability—a number of data exchange projects
  • NACHA Mandate Overview—operating rules for automated payments

We have a full compliance and implementation team staying ahead of the evolving mandates and moving forward as information is available. Most mandates don’t require any action by employer groups; however, we’ll keep you informed by spotlighting a mandate in each issue of News from Blue. 

Spotlight mandate: Cost-sharing transparency on identification cards

As part of the Consolidated Appropriations Act, this new government mandate requires physical and electronic member ID card changes that clarify cost-sharing amounts. The new identification cards must disclose:

  • In-network and out-of-network deductibles
  • Any out-of-pocket maximums
  • A telephone number and website address through which members may seek assistance

Sample Proposed ID Card (may vary slightly by plan)

Who it applies to: Fully insured and self-funded group health plans (including grandfathered)

Effective date: Plan years beginning on or after Jan. 1, 2022

Action required by employer group: BCBSND will be sending new cards directly to members. You may want to let your employees know a new card is on the way.