Know Before You Go Act of 2016
This bill amends the Public Health Service Act to permit health insurers to include, for plan year accounting purposes, activities related to a transparency tool as activities that improve health care quality. (An insurer must provide a rebate to enrollees if the insurer spends less than a certain percentage of premium revenues on clinical services and activities that improve health care quality.) A transparency tool is a website and telephone support that provides quality of care and cost sharing comparisons among in-network providers.
Such accounting for a plan year is permitted only for insurers that have: (1) significantly increased the percentage of enrollees using a transparency tool compared to the previous year, (2) provided cost sharing estimates for episodes of care upon request, and (3) made available a list of high deductible health plans offered by the insurer to each individual seeking coverage from the insurer.
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