On October 6, 2026, the Departments of Labor, Health and Human Services, and the Treasury issued a final rule that makes significant changes to the Transparency in Coverage requirements. The final rule is effective December 7, 2026, with many of the consumer disclosure changes applying for plan years beginning on or after January 1, 2027. Although many plan sponsors have largely left Transparency in Coverage compliance to their Third Party Administrators (TPAs) or carriers, the final rule may require them to become more involved.
For plan sponsors, one of the most significant changes under the new rule is an attestation requirement. Plan sponsors must attest, for each applicable machine-readable file, that to the best of their knowledge and belief, all required information has been included and that the information is true, accurate, and complete as of the date reflected in the file. The files must also identify the plan sponsors' chief executive officer, president, or senior official designated to oversee data encoding. A plan may, under specified circumstances, enter into a written agreement under which another party, such as a TPA, makes the attestation on the plan's behalf and identifies an appropriate senior official of that party.
The existing rules already require plans to make personalized cost-sharing information available through an internet-based self-service tool and, upon request, in paper form. However, the new rule now requires plans to make personalized cost-sharing information available by telephone, in addition to the existing online and paper methods, using the customer-assistance telephone number provided on the participant's plan identification card. The information must be accurate at the time of the request and provided at that time. The rule generally permits plans to limit a telephone request to information for no fewer than 20 providers per operational day.The final rule also addresses the longstanding difficulty participants have had in locating the required machine-readable files. Plans must maintain a standardized Text File that identifies where the required machine-readable files are located and provides a monitored email address for questions or issues. A plan without its own public website may arrange for a TPA or other service provider to host the file, but the plan remains responsible for compliance even when the hosting function is delegated.
Most plan sponsors will continue to rely on their TPAs and carriers for compliance, but the new attestation requirement makes it increasingly important for sponsors to understand what their vendors are doing and to ensure their contracts appropriately address responsibility for compliance. If you have any questions or would like more information on the transparency reporting requirements or other employee benefits compliance issues, please contact a member of Bricker Graydon Wyatt's Employee Benefits practice group.
