Aug 15, 2023
The CAA Prohibition on Gag Clauses provision requires an annual Gag Clause Prohibition Compliance Attestation (GCPCA). UnitedHealthcare will make the attestation for fully insured customers as required. For Level Funded and self-funded (ASO) customers, UnitedHealthcare will provide a confirmation of compliance to support the customer’s responsibility to complete their own attestation. Attestations are required by December 31, 2023.
The gag clause prohibition and attestation requirements apply broadly to all health insurance issuers and group plan sponsors offering fully insured, Level Funded or self-funded (ASO) coverage in the group and individual markets, including grandfathered and transitional relief plans, student health plans, individual coverage offered through an association, ERISA plans, non-federal governmental plans, and church plans. Excepted benefits are not included in the requirement.
Level Funded/Self-Funded Plans: Action Needed
Self-funded group health plans and health insurance issuers offering coverage in the individual and group markets must submit a GCPCA annually to confirm that the plan or issuer is complying with the gag clause prohibition.
The first attestation — due no later than December 31, 2023 — covers the period beginning December 27, 2020, through the date of the attestation.
Each subsequent attestation covers the period since the preceding attestation and will be due December 31 of each year. HHS has established a web portal and instructions for submitting the attestations.
UnitedHealthcare will not submit the attestation. Instead, UnitedHealthcare will provide a confirmation of compliance, which the customer may use to support its own attestation submission to the HHS portal. This confirmation of compliance will be available by the end of Q3 each year, and communications will be sent when it is available.
Fully Insured Groups: No Action Needed
UnitedHealthcare will make the attestation to the HHS portal as required. No action is required by the customer to attest for their fully insured business with UnitedHealthcare.
Other Plan Types: Action May Be Needed
- Groups with External Arrangements: Customers/plan sponsors with special arrangements such as CSP/GSP and carve outs including OptumRx Direct are responsible for working with outside entities to submit a corresponding attestation.
- Mixed Funded Groups: UnitedHealthcare will submit the attestation for fully insured plans. The customer will need to complete the attestation for the self-funded plans.
For more information, see the Gag Clause section of UnitedHealthcare's Consolidated Appropriations Act FAQ document, or contact your Amwins Connect Sales Representative.
