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Doctor's Desk

Transparency In Coverage

Machine Readable Files

Good Faith Reliance

The TiC Final Rule provides some protection for good faith compliance. Under the final rule, a group health plan that is acting in “good faith” and with “reasonable diligence” will not fail to comply solely because it makes an error or omission in the disclosure requirement. As well, a plan or insurer will not fail to comply solely because, despite acting in good faith and with reasonable diligence, its internet website is temporarily inaccessible (e.g., for the public disclosure requirement). The final rule further states that to take advantage of these protections, the plan or issuer must make the information available as soon as practicable. Plans sponsors should prepare a deliberate, written compliance plan to demonstrate good faith efforts and reasonable diligence if unable to fully comply with disclosure requirements by July 1, 2022.

If the required disclosure is provided by a third party (e.g., a third-party administrator) and the third party is out of compliance, the plan will not be out of compliance unless it knew or reasonably should have known that the information provided is incomplete or inaccurate.

Mike Mandolfo - Key Speaker
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