Common use of Transparency in Coverage Clause in Contracts

Transparency in Coverage. Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, in accordance with the requirements set forth at 45 C.F.R. § 156.220, including information relating to claims payment policies and practices, financial disclosures, enrollment, disenrollment, denials, rating practices, cost- sharing, out-of-network coverage, and Enrollee rights. Contractor shall timely respond to an Enrollee’s request for cost sharing information and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner upon request. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language, in accordance with 45 C.F.R. § 156.220(c).