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No Surprises Act — Surprise Billing Protections Notice

Explains protections against balance billing for emergency and certain out-of-network care. Post publicly and include with plan materials.

Companies Eligible

Every group health plan and issuer; in practice the carrier (insured) or TPA (self-funded) does the posting and the EOB inclusion.

Confirm in writing which vendor handles it. If the client maintains a public website for the plan, the notice is posted there as well.

What it is

The model notice “Your Rights and Protections Against Surprise Medical Bills” explains the balance-billing protections for emergency care, out-of-network care at in-network facilities and air ambulance, what the participant is responsible for, and how to complain. Plans must make it publicly available and include it with explanations of benefits for the covered services.

What needs to be done

  • When: Continuously posted on a public website and included with EOBs. Adding it to the annual packet is good practice, not a substitute.
  • To whom: Participants and beneficiaries.
  • Who performs: Carrier or TPA. Employer posts on its own plan website if it has one.
  • Customize: Plan name and contact. For insured plans, add the state's own balance-billing protections where the state has them; Florida has its own law for insured plans, so Florida-sitused policies should reference it.
  • Deliver: Website, EOBs, packet.
  • Keep: Written confirmation from the carrier or TPA and the URL of the posting.

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