58-17K-3. Cost-sharing information disclosed--Required internet method and format.

The cost-sharing information to be provided under this chapter shall be made available without a subscription or other fee through a self-service tool on a website that provides real-time responses based on cost-sharing information that is accurate at the time of request. A health insurer shall ensure the self-service tool allows enrollees to:

(1)    Search for cost-sharing information for a covered item or service by an in-network provider by inputting:

(a)    A billing code or a descriptive term;

(b)    The name of an in-network provider; and

(c)    Other factors utilized by the health insurer that are relevant for determining the applicable cost-sharing information;

(2)    Search for an out-of-network allowed amount, percentage of billed charges, or other rate for a covered item or service by an out-of-network provider by inputting:

(a)    A billing code or a descriptive term; and

(b)    Other factors utilized by the health insurer that are relevant for determining the applicable out-of-network allowed amount or other rate; and

(3)    Refine and reorder search results based on geographic proximity of in-network providers and the amount of the enrollee's estimated cost-sharing liability.

Source: SL 2021, ch 213, § 3.