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The No Surprises Act: What You Need to Know

Jun 23, 2022Industry News

Let’s say your child broke her arm and you head to the emergency room. The hospital is in-network, the doctor who treats her is in-network, but the radiologist is out-of-network. You don’t realize this until you get your bill and see the charges. Before the No Surprises Act, you would be responsible for those out-of-network copays, coinsurance and/or deductible amounts.

That’s all changing for UFCW National Health and Welfare Plans beginning October 1, 2022.

The No Surprises Act takes surprise billing (sometimes called balance billing) off the table in two situations:

  • emergency services
  • certain services at an in-network hospital or ambulatory surgical center

In most cases, out-of-network charges you incur in either of these circumstances will be treated as in-network. That means you’ll only be responsible for paying your share of the cost (like the copayments, coinsurance, and/or deductibles that you would pay if the provider or facility was in-network). The Plan will make up the difference and pay providers and facilities directly.

Questions? Read more about the No Surprises Act and what it means for you in this Summary of Material Modifications [link to Plan’s SMM].