In the evolving landscape of employee benefits, staying compliant with legal requirements is imperative for organizations. A critical element of this compliance is understanding and adhering to the gag clause prohibition compliance attestations (GCPCAs) as mandated by recent legislation. This guide is designed to provide you with clear, detailed instructions on the GCPCA submission process, ensuring your organization meets the crucial deadline of December 31, 2023.
What is the Health Plan Gag Clause Attestation?
The gag clause attestation is part of the CAA’s effort to enhance healthcare transparency. It prohibits health plans from including clauses that restrict the sharing of cost and quality information. Employers must attest whether their health plans comply with this requirement.
Annual GCPCA Requirements
All health plans are now required to submit an annual GCPCA to confirm compliance with the gag clause prohibition. The initial submission, covering the period from December 27, 2020, to the date of attestation, is due by December 31, 2023. Subsequent attestations will be due annually on December 31st.
For more on this, visit the Department’s GCPCA guidelines.
Covered Health Plans
The GCPCA requirement applies to a broad range of health plans, including ERISA group health plans, both fully insured and self-funded plans, non-federal governmental plans, and church plans. However, standalone dental and vision plans, FSAs, and HRAs are exempt from this requirement.
GCPCA Submission Process
The submission process varies based on the type of plan:
- Fully Insured Plans: Employers can generally rely on their insurance carriers for GCPCA submission. It’s prudent to obtain written confirmation from carriers about their compliance.
- Self-Funded Plans: While employers can contract service providers for submission, the ultimate responsibility lies with them in case of non-compliance.
For further details, consult the FAQs on GCPCA submission.
How to Submit GCPCA
To submit your GCPCA, start by accessing the GCPCA webform. The process involves filling out required fields and uploading necessary documentation. Detailed instructions can be found in the CMS user manual, which provides step-by-step guidance.
Additional GCPCA Submission Process Notes
For most single-employer group health plans, one GCPCA submission per entity is sufficient. However, for multiple reporting entities, such as carriers or TPAs, a downloadable GCPCA reporting entity Excel template is required.
For comprehensive instructions, refer to the GCPCA manual.
Need Help?
With the first GCPCA due by December 31, 2023, it’s crucial for your organization to begin the submission process promptly. This guide aims to simplify your journey towards compliance. Remember, eBen is here to assist you with any questions or concerns. If you have questions or need guidance, contact a compliance expert or reach out to our team here.
