The appro­pri­a­tions act passed ear­li­er this year con­tains a pro­vi­sion that expands the tra­di­tion­al Expla­na­tion of Ben­e­fits to what is now called an Advanced EOB.  Start­ing with plan years with a renew­al of Jan­u­ary 1, 2022, group health plans must pro­vide this on request.  This must contain

  1. Whether or not the provider or facil­i­ty is in net­work – if so, the con­tract­ed rate under the plan for the provider or service
  2. Good faith esti­mate of the cost of ser­vices to be pro­vid­ed, which includes the total cost of ser­vices, the amount of par­tic­i­pant cost shar­ing, the accrued amounts already met and the amount the plan is respon­si­ble for pay­ing (yes, just like EOBs are sup­posed to already)
  3. Dis­claimers that this is only an estimate