Price Comparison Transparency Tool Expanded for 2024

1.5 minute read

In 2024, group health plans and issuers must expand their internet-based price comparison tool for enrollees, participants, and beneficiaries. It will need to include all covered items, services, and drugs. The tool was created to help consumers shop and compare prices on a variety of services and prescription drugs. Upon request, this information can also be provided in paper form or over the telephone.

Compliance Deadlines

For plan years beginning on or after January 1, 2023, price comparisons information was required for 500 shoppable items, drugs, and services. For plan years beginning on or after January 1, 2024, price comparison information must be available for all covered items, drugs, and services.

Action Steps

Most employers rely on their issuers or third-party administrator to develop and maintain the price comparison tool and provide related disclosure. To ensure compliance, employers may want to consider:

• Fully insured health plans. These plan types are not required to provide the price comparison tool if the issuer agrees in writing to provide the tool. Employers may want to confirm with their insurer that they are providing the tool and it’s addressed in a written agreement.
• Self-insured health plans. Employers with this plan type may want to reach out to their third-party administrator to confirm that they are providing this tool and it’s addressed in a written agreement. Employers may also want to monitor the service provider’s compliance with this requirement, as it is the employer’s legal responsibility for this tool regardless of who provides it on their behalf.

Download the bulletin for more details.