By Dalita Collins, Director, Policy
Americans increasingly manage important aspects of their lives online—from banking and health care to employment and benefits information. The rules governing how individuals receive information about their health benefits should reflect that reality. The Department of Labor’s (DOL) proposed rule on electronic disclosure by group health plans under ERISA represents an important step toward modernizing these requirements and creating a framework that better reflects how people communicate today. The rule would make it easier for health plans to provide required information to patients electronically.
The Pharmaceutical Care Management Association (PCMA) applauds DOL’s goal of facilitating greater use of electronic communications and encourages the Department to finalize the proposed rule with limited modifications. On September 21, PCMA submitted comments supporting the proposed rule.
Electronic delivery can give patients faster and more convenient access to important information about their health plan while reducing the significant administrative resources associated with printing, processing, mailing, and maintaining paper communications. For employers, health plans, and their service providers, a clearer and more consistent electronic disclosure framework can also simplify administration and allow resources to be focused more effectively on delivering health benefits.
Modernizing these requirements is also about meeting patients where they are. Consumers routinely use email, online portals, mobile devices, and other digital platforms to access sensitive and important information. Electronic delivery can make health plan disclosures easier to receive, retain, search, and retrieve when needed, while allowing updated or corrected information to reach participants more quickly.
At the same time, modernization should preserve meaningful flexibility and choice. PCMA supports an approach that allows plans to use electronic delivery where it is efficient and appropriate without requiring participants who prefer or need paper communications to abandon them.
In the comments, PCMA also encouraged DOL to provide appropriate flexibility regarding costs associated with certain participant-requested services. Required ERISA disclosures should remain accessible without unnecessary charges, but plans may encounter requests that go beyond their ordinary disclosure obligations, such as multiple duplicate copies or specialized delivery formats that require additional processing.
PCMA further encouraged DOL to clarify that reasonable costs associated with these limited, participant-requested services may be allocated appropriately, provided any fee is reasonable, disclosed in advance, and does not impede access to information required under ERISA.
Ultimately, DOL’s proposal offers an opportunity to bring ERISA’s disclosure framework more fully into the digital era while maintaining important protections for participants. PCMA supports the effort to establish a modern, flexible approach that recognizes the benefits of electronic communication, reduces unnecessary administrative burdens, and preserves access for individuals who need or prefer paper communications. With the targeted clarifications outlined in our comments, we encourage DOL to move forward with finalizing this important modernization effort.
The e-delivery rule stands in contrast to the harmful, duplicative PBM rule proposed by DOL that will lead to higher costs and less competition in the PBM market. Mid-market PBMs have been sounding the alarm, warning that the rule will drive up compliance costs, pull resources away from growth and innovation, and tilt the playing field further toward the largest incumbents — the opposite of what competition policy should do.
DOL should promote policies that modernize communications and help patients like the electronic disclosure rule and take another look at new regulations that will raise costs with no meaningful benefit for patients, like the pending PBM transparency rule.
Read the full comment letter HERE.