CAA 2021

No Surprises Act

This legislation provides rules and processes to protect health plan members from balance billing that may arise from non-network provider utilization that is out of the member's control.  An example could be, an individual having surgery at an in-network facility, by an in-network physician, but the anesthesiologist, which they have no control over, is out of network.

Attached is the No Surprise Act Model Notice



Publicly Available Cost Information/Transparency in Coverage

This legislation requires health insurers and group health plans to make available negotiated rates for in-network providers and allowed amounts for out-of-network providers, derived from historical claims.

https://www.anthem.com/machine-readable-file/search