42 U.S.C. § 300gg–46 — Disclosure to enrollees of individual market coverage

submitted 82 years ago by Pub. L. 116-260 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 247 words · no verdicts yet

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Insurers selling individual or short-term health plans must tell customers about payments made to agents and brokers. They must disclose this before the person picks a plan, and again on enrollment paperwork. Insurers must also report these payments to the government each year.

(a) In general: An insurer that sells individual health coverage, or short-term limited-duration coverage, must make disclosures to enrollees (subsection (b)) and reports to the Secretary (subsection (c)) about direct or indirect compensation the insurer pays an agent or broker connected to enrolling people in that coverage. (b) Disclosure: The insurer must disclose to the enrollee the amount of direct or indirect compensation given to an agent or broker for services connected to plan selection and enrollment. This disclosure must be (1) made before the person finalizes their plan choice, and (2) included on any paperwork confirming the person's enrollment. (c) Reporting: Each year, before open enrollment begins, the insurer must report to the Secretary any direct or indirect compensation it gave an agent or broker connected to enrolling people in the coverage. (d) Rulemaking: Within one year of December 27, 2020, the Secretary must finish, through notice-and-comment rulemaking, rules on the timing, form, and manner for the disclosures in (b) and the reports in (c). This rulemaking may also adjust notice requirements to fit the different process for plan renewals, so enrollees get full, timely information.

the actual law source: uscode.house.gov ↗public domain

(a) In general

A health insurance issuer offering individual health insurance coverage or a health insurance issuer offering short-term limited duration insurance coverage shall make disclosures to enrollees in such coverage, as described in subsection (b), and reports to the Secretary, as described in subsection (c), regarding direct or indirect compensation provided by the issuer to an agent or broker associated with enrolling individuals in such coverage.

(b) Disclosure

A health insurance issuer described in subsection (a) shall disclose to an enrollee the amount of direct or indirect compensation provided to an agent or broker for services provided by such agent or broker associated with plan selection and enrollment. Such disclosure shall be—

(1)

made prior to the individual finalizing plan selection; and

(2)

included on any documentation confirming the individual’s enrollment.

A health insurance issuer described in subsection (a) shall annually report to the Secretary, prior to the beginning of open enrollment, any direct or indirect compensation provided to an agent or broker associated with enrolling individuals in such coverage.

(d) Rulemaking

Not later than 1 year after December 27, 2020, the Secretary shall finalize, through notice-and-comment rulemaking, the timing, form, and manner in which issuers described in subsection (a) are required to make the disclosures described in subsection (b) and the reports described in subsection (c). Such rulemaking may also include adjustments to notice requirements to reflect the different processes for plan renewals, in order to provide enrollees with full, timely information.

Source credit: (July 1, 1944, ch. 373, title XXVII, § 2746, as added Pub. L. 116–260, div. BB, title II, § 202(c), Dec. 27, 2020, 134 Stat. 2899.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 116-260 · 134 Stat. 2899

A history note hasn’t been published yet. The record shows enactment by Pub. L. 116-260 on 1944-07-01.

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