Gag Clause Prohibition Compliance Attestation Due 12/31/23

Posted on September 15, 2023

Gag Clause Prohibition Compliance Attestation (GCPCA)
Due December 31, 2023

How To Comply (NY, NJ, CT): 

• Fully-Insured Groups are NOT required to take any action. The carrier will submit on their behalf.
• Self-Insured and Level Funded Groups can submit their GCPCA via Webform to satisfy this requirement. However, some but not all carriers, will be submitting on behalf of the group.* Below is a link to the Webform, FAQ’s and supporting documentation.  
  • Enter Webform Now for a GCPCA (Click on “Don’t have a code or forgot yours?” to obtain a login code.)
  • Frequently Asked Questions
  • Instructions for submitting the GCPCA
  • User Manual for submitting the GCPCA
  • GCPCA Reporting Entity Excel Template

 *Aetna has advised us that for AFA business in the small group and middle market that they will be submitting the attestation on behalf of the employer. Anthem BCBS of NY and CT have advised us that they sent an online questionnaire to their Self-Insured and AFA Groups that needed to be completed by August 15th. If the Questionnaire was submitted by August 15th Anthem will submit the attestation on behalf of the group. If the group did not complete the questionnaire, they will need to submit the attestation themselves. We will advise on any additional carrier information as it becomes available to us.

Note: Emblem has not yet advised on their policy for GCPCA. 

What is Gag Clause Prohibition Attestation?

• Group health plans and health insurance issuers offering group or individual health insurance coverage must annually submit a Gag Clause Prohibition Compliance Attestation (GCPCA) to the Department of Health and Human Services (HHS), which is collecting the attestations on behalf of the Departments of Labor, HHS, and the Treasury (the Departments).
• These provisions became effective December 27, 2020 with the first GCPCA due no later than December 31, 2023. Subsequent attestations are due by December 31 of each year thereafter.
• The GCPCA is an attestation of compliance with Internal Revenue Code (Code) section 9824, Employee Retirement Income Security Act (ERISA) section 724, and Public Health Service (PHS) Act section 2799A-9, as applicable.
• These provisions generally prohibit plans and issuers from entering into certain provider agreements that would prevent the disclosure of cost or quality of care information or data, and certain other information to active or eligible participants, beneficiaries, enrollees, plan sponsors, or referring providers, or restrict the plan or issuer from sharing such information with a business associate, consistent with applicable privacy regulations.
• A health care provider, network or association of providers, or other service provider may place reasonable restrictions on the public disclosure of this information.