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The Transparency in Coverage Act amends the Employee Retirement Income Security Act to require group health plans and health insurance issuers to disclose pricing and coverage information to the public and participants. The bill mandates that plans provide real-time cost-sharing estimates, in-network and out-of-network rates, claims payment policies, and enrollment data in plain language through online tools and mobile applications. It also reforms pharmacy benefit management services by establishing standards for drug pricing disclosures, prohibiting certain PBM practices, and requiring transparency in rebate and fee arrangements.
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