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 information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language.

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, Enrollees the data as required by the Exchangeno later than March 31st of each year. This includes information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language.

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, Enrollees the data as required by the Exchange. This includes information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language.

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, Enrollees the data as required by the Exchange. This includes information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language.

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, Enrollees the data as required in Attachment 13, or as requested by the Exchange. This includes information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-cost- sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language.