ACA Transparency Reporting

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On August 11, 2015, the Departments of Labor, Health and Human Services and the Treasury (collectively, the Departments) issued FAQ Part XXVIII addressing transparency reporting requirements under the Affordable Care Act (ACA).  The ACA requires issuers of Qualified Health Plans (QHPs) offered on public Exchanges to disclose certain information to the Exchange, the Department of Health and Human Services, the state insurance commissioner and the public.

These reporting requirements also apply to non-grandfathered plans (including large group and self-insured plans) and issuers offering coverage outside of a public Exchange.  While the information to be reported is similar, these plans and issuers will not be required to report to the Exchange.

Implementation was delayed pending the release of regulatory guidance and the Departments are now beginning to develop guidance.  FAQ XXVII explains that issuers offering QHPs on public Exchanges utilizing the platform will begin transparency reporting first, which will be followed by issuers offering QHPs through State-based Exchanges not using the federal platform.

The Departments note that transparency reporting for non-QHP issuers and non-grandfathered plans will likely differ from, and be more streamlined than, what is required by issuers of QHPs.  They also note that implementation will not occur until after reasonable notice and opportunity for comment are provided, as well as allowing for sufficient time to come into compliance with the final regulations.