Small Business Benefits

Federal Mandates

Consolidated Appropriations Act, 2021, including the No Surprises Act, and The Transparency in Coverage Rule

The Consolidated Appropriations Act, 20211, including the No Surprises Act 2, ushers in new federal mandates, such as those designed to prevent surprise medical bills. And, as provisions in the Transparency in Coverage Rule3 make healthcare price information publicly accessible, consumers will gain even more information to make informed healthcare decisions. 

The changes impact most employer-sponsored, self-funded group health benefit plans. From the beginning, our dedicated team has kept abreast of policy discussions surrounding the need to prevent surprise medical bills and to provide more transparency in healthcare pricing. As requirements from all measures take effect, we will keep brokers updated on important provisions; help plans administered by Star Marketing and Administration, Inc. comply with applicable aspects; and educate members about these sweeping changes.

A timeline for provisions follows for self-funded ERISA plans.

Consolidated Appropriations Act, 2021: Data due to the federal government by June 1, 2023

Prescription Drug Data Collection

The Consolidated Appropriations Act, 2021, requires the submission of certain data by June 1, 2023, for the Prescription Drug Data Collection (RxDC) report. The data will show spending on prescription drugs and healthcare services, prescription drugs that account for the most spending, drugs that are prescribed most frequently, prescription drug rebates from drug manufacturers, the required contribution for each employer-sponsored plan in 2022 for covered employees, as well as cost-sharing for covered employees.

We will submit data annually for each group. On March 6, 2023, we will send an email to sponsors of self-funded health benefit plans requesting information that is needed to complete the submission accurately.

Transparency in Coverage Rule and No Surprises Act: Effective for plan years beginning on or after 1/1/23 and 1/1/24

Consolidated Appropriations Act, 2021: Data due to the federal government by Dec. 27, 2022

Transparency in Coverage Rule: effective 7/1/22

No Surprises Act provisions: effective for plan years beginning on or after 1/1/22

Provisions with effective date delayed pending federal guidance

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No Surprises Act Overview

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Transparency in Coverage summary

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FAQs About Affordable Care Act And Consolidated Appropriations Act, 2021 Implementation Part 49

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