The Transparency in Coverage Act requires employer-sponsored health plans and health insurance issuers offering group coverage to publicly disclose detailed pricing information, including negotiated in-network rates, out-of-network payment amounts, and drug pricing data, through machine-readable files and, starting in 2026 or 2027, real-time online tools. It also gives patients and providers the right to request personalized cost-sharing estimates before receiving care, showing expected out-of-pocket costs, deductible balances, and any prior authorization requirements. Separately, the bill imposes new transparency rules on pharmacy benefit managers (PBMs), requiring them to regularly report detailed data to employers on drug pricing, rebates, fees, and pharmacy ownership arrangements, with penalties of up to $10,000 per day for noncompliance and up to $100,000 for knowingly submitting false information. The law also bars pharmacies from being penalized for telling patients when paying out-of-pocket would be cheaper than using insurance. Most provisions would apply to health plans starting in 2025, with a federal advisory committee also created by January 2025 to help ensure the new pricing data is useful and accessible, operating until 2028. The bill primarily affects employers who sponsor health plans, health insurers, PBMs, and ultimately employees and patients who gain more visibility into health care costs before receiving treatment.