Common use of Transparency and Quality Reporting Clause in Contracts

Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to the Exchange and Enrollees the data as required by the Exchange. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with regard to any out-of-network coverage, and Enrollee rights. Contractor may include pre- treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language. (b) Contractor shall timely respond to an Enrollee’s request for cost sharing information, and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.

Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to the Exchange and Enrollees the data as required by the Exchange. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with regard to any out-of-network coverage, and Enrollee rights. Contractor may include pre- treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this Section section to the Exchange and Enrollees in plain language. (b) Contractor shall timely respond to an Enrollee’s request for cost sharing information, and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.

Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s Contractor¶s coverage, and report to the Exchange and Enrollees the required data as required by the Exchangeno later than March 31st of each year. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with regard to any out-of-of- network coverage, and Enrollee rights. Contractor may include pre- pre-treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language. (b) Contractor shall timely respond to an Enrollee’s Enrollee¶s request for cost sharing information, and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.

Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. CFR § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to the Exchange and Enrollees the required data as required by the Exchangeno later than March 31st of each year. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with regard to any out-of-of- network coverage, and Enrollee rights. Contractor may include pre- pre-treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language. (b) Contractor shall timely respond to an Enrollee’s request for cost sharing information, and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.