The Departments of Labor, Health and Human Services, and the Treasury (collectively, “the Departments”) issued FAQ Part 55, providing guidance as it relates to certain aspects of the No Surprises Act (“NSA”) and the Transparency in Coverage (“TiC”) final regulations. FAQ 55 includes 23 questions and answers. The guidance is lengthy and very detailed.

Attached you will find some of the key highlights of the guidance.

Employer Action

The guidance provides helpful clarification. Many aspects of the NSA and TiC rules are functions of plan administration and claims payment; support from carriers and third-party administrators (“TPAs”) is essential for compliance.

For fully insured plans, these requirements should be handled by the carrier.

For a self-funded plan (including level-funded), the plan is ultimately responsible for compliance and should work with third-party administrators to ensure the plan is administered in accordance with the NSA and TiC rules.

For more information click on the attached link. New FAQ Addresses NSA And TiC Rules – 091222U