What the No Surprises Act means for Employers
For employer-funded health plans, the NSA demands that significant requirements are met in provider/plan billing disputes. Check your health care plan for any restrictions on providers and other administrative particulars.
The NSA also creates some new requirements for ID cards and cost estimates, including:
- Online and printed ID cards listing all deductibles and OON maximums, as well as insurer contact information
- Cost estimates for services that are scheduled three days or more in advance. This estimate is based on the employee’s plan and will be sent to them via email or mail.
It’s a good idea to let your employees know that these changes are coming and how they will be protected once the No Surprises Act goes into effect. It is important for your employees to understand their rights under this new law.
What is Independent Dispute Resolution (IDR)?
Independent Dispute Resolution (IDR) is the process to settle any disputes related to reimbursement for the types of OON services outlined in the NSA.
Under the new legislation, if there is a dispute over the amount paid to the provider, your covered employees are only responsible for the amount they would pay if the services were provided by an in-network provider.
The provider and the insurance plan are responsible for coming to a resolution with the help of an independent arbitrator, in a process that will look like this: