WHAT PLANS ARE REQUIRED TO COMPLY?
Fully insured and self-insured group health plans, including ERISA plans, non-Federal governmental plans, and church plans must comply with the gag clause prohibition. These requirements apply regardless of whether a plan or coverage is considered to be a grandfathered health plan.
WHAT IS THE GAG CLAUSE PROHIBITION?
A federal regulation creating a prohibition on group health plans and health insurance issuers from entering into any agreement with a health care provider, network, third-party administrator (TPA), or other service provider offering access to a network of providers that included “gag clause(s)”.