--- title: Communicating the No Surprises Act to Your Employees and Plan Members description: Balance billing happened about once in every five emergency room visits. The No Surprises Act puts an end to this practice. --- [Segal Benz Blog ](https://segalbenz.com/blog) # [Communicating the No Surprises Act to Your Employees and Plan Members](https://segalbenz.com/blog/communicating-the-no-surprises-act-to-your-employees-and-plan-members) Written by [Chris Fielder](https://segalbenz.com/blog/author/chris-fielder-staff-writer) | January 25, 2022 Bad news: You fell off your bike last year, broke your ankle, and needed immediate surgery. You’re on the mend now, but a $15,000 bill came in the mail from the out-of-network orthopedist who treated you. It was an emergency! What were you supposed to do? Last year, you’d be on the hook for $15,000. Fortunately, no more. The [No Surprises Act](https://www.congress.gov/bill/116th-congress/house-bill/3630) took effect on January 1, 2022, and it’s a big win for health care consumers—you and your people included. No longer can doctors, health care facilities, and insurance companies charge you for out-of-network care that you didn’t approve ahead of time. ## How the No Surprises Act Works It’s not your fault if you visit an in-network hospital and then get treated by an out-of-network doctor. In fact, an expansive 2020 joint study by [The Peterson Center on Healthcare and the Kaiser Family Foundation](https://www.healthsystemtracker.org/brief/an-examination-of-surprise-medical-bills-and-proposals-to-protect-consumers-from-them-3/) found that it was common. The practice, called **balance billing**, happened to participants of large employer plans in 18% of emergency room visits and 16% of in-network hospital stays.  That’s where the No Surprises Act comes in. It protects consumers from balance billing in two circumstances: medical emergencies (like your bike mishap) and visits to in-network facilities. Here’s a nonemergency example. You plan a month in advance to get shoulder surgery. You go to your insurance carrier’s website and find an in-network hospital. You have surgery and the procedure is a success. You did everything right. But wait! The anesthesiologist who knocked you out wasn’t part of your plan’s network. A few weeks later, you get a $12,000 bill for the difference between what your anesthesiologist charged and what your insurance carrier agreed to pay. That’s balance billing. And it’s a thing of the past, unless you **consent in writing to receive** out-of-network care. ## Next Steps for Plan Sponsors Self-funded plans and third-party administrators must make information about the No Surprises Act available on a **public website**, which means username and password protections aren’t allowed. And, if you’re a plan sponsor, it’s important to act now. The Department of Labor will start enforcing the following requirements for plan years beginning on or after January 1, 2022: - **Post a notice of No Surprises Act requirements online.** Both the plan’s public website and all Explanation of Benefits statements for these claims must spell out a patient’s rights under the No Surprises Act’s balance billing prohibitions. You may want to start with the Department of Labor’s [model notice](https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/no-surprises-act) for this. - **Make network provider directories available.** Include a list of contracted network providers and facilities on a public website (or a link to the medical plan network provider’s website). Print directories must refer to a website where this information is available. - **Upload documents with rate information.** These files must disclose in-network rates and past out-of-network charges for covered items and services. They also must be **machine-readable** and uploaded to the plan’s public website by July 1, 2022 (or be available by a link from the plan’s public website to the medical plan provider’s website). ## Communications Reminders The No Surprises Act protects consumers from receiving many life-altering medical bills when they’re most vulnerable. Regular communication will help your people take to heart the enormity and importance of this change. **Continue to stress in-network care.** Consumers aren’t protected from balance billing if they actively choose an out-of-network facility or doctor in nonemergency situations. **Emergencies are covered.** With the exception of ground ambulance services, out-of-network doctors and facilities cannot balance bill for care during a medical emergency. **Health literacy is still low.** Health care concepts are complex and generally unfamiliar. Talk to your people about health care often, and sprinkle easily digestible messages about the No Surprises Act throughout your communications.  **Add information about the No Surprises Act to your organization’s benefits website.** Balance billing was common just a few weeks ago. Communicating what’s changed and explaining how it affects your people reinforces that you care about their needs, health, and finances. If your organization doesn’t have a password-free benefits website yet, now is a great time to get one up and running! It makes communicating [everything else](https://segalbenz.com/blog/five-common-barriers-to-engagement) more effective. We're proud to work with organizations that value their people. If you want to learn more, [we’d love to talk](https://4249962-hs-sites-com.sandbox.hs-sites.com/contact-us). This blog was co-authored by Andrew Kaplan, VP Senior Consultant.   ## Read Next - [Why Your Communications Strategy May Need a COVID-Related Upgrade](https://segalbenz.com/blog/research-statistics-guide-communications-strategy) - [Inspire and Engage Your People with Communications That Work](https://segalbenz.com/blog/case-studies-to-inspire-your-communications) - [What You Need to Communicate About the SECURE Act](https://segalbenz.com/blog/secure-act-communications) [View full post](https://segalbenz.com/blog/communicating-the-no-surprises-act-to-your-employees-and-plan-members) ```json { "@context" : "http://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Chris Fielder" }, "dateModified" : "2024-05-29T15:55:26.249Z", "datePublished" : "2022-01-25T08:00:00Z", "headline" : "Communicating the No Surprises Act to Your Employees and Plan Members", "image" : { "@type" : "ImageObject", "height" : 341, "url" : "https://f.hubspotusercontent10.net/hubfs/4249962/SB-Blog-nsa_web-600px-021122.png", "width" : 600 }, "mainEntityOfPage" : "https://segalbenz.com/blog/communicating-the-no-surprises-act-to-your-employees-and-plan-members", "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "height" : 60, "url" : "/hs/hsstatic/content_shared_assets/static-1.4092/img/default-amp-logo.png", "width" : 60 }, "name" : "Segal Benz Blog" } } ```