This provision overlaps between CAA Price Comparison Tool and TCFR Cost Sharing Estimator Tool.
CAA Plan Comparison Tool section 114 requires that group health plans and insurance issuers maintain a “price comparison tool” available via phone and website that allows members and participating providers to compare cost-sharing for items and services by any participating provider.
TCFR Cost Sharing Estimator Tool requires that group health plans and insurance issues make available to members, personalized out-of-pocket cost information for covered items and services, through a self-service tool and in paper within 2 days upon request.
TFCR Machine Readable File provision requires three types of files to be available to make information useful for the average consumer (e.g. .XML excel file); In-network rates; out-of-network allowed amounts; and prescription drug in-network rates.
Market impact of this provision effects Individual Family Plan (IFP), Small Business Markets (SBM), Core, Premier, Administrative Services Only (ASO) and Shared Advantage (SA) lines of business.
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