INTERNET-BASED SELF-SERVICE TOOL

(a) A health benefit plan issuer or administrator may develop and maintain an Internet-based self-service tool to provide a disclosure required under this subchapter. (b) Information provided on the self-service tool must be made available in plain language, without a subscription or other fee, on an Internet website that provides real-time responses based on cost-sharing information that is accurate at the time of the request. (c) A health benefit plan issuer or administrator shall ensure that the self-service tool allows a user to: (1) search for cost-sharing information for a covered health care service or supply by a specific network provider or by all network providers by inputting: (A) a billing code or descriptive term at the option of the user; (B) the name of the network provider if the user seeks cost-sharing information with respect to a specific network provider; or (C) other factors used by the issuer or administrator that are relevant for determining the applicable cost-sharing information, including the location in which the service or supply will be sought or provided, the facility name, or the dosage; (2) search for an out-of-network allowed amount, percentage of billed charges, or other rate that provides a reasonably accurate estimate of the amount the issuer or administrator will pay for a covered health care service or supply provided by an out-of-network provider by inputting: (A) a billing code or descriptive term at the option of the user; or (B) other factors used by the issuer or administrator that are relevant for determining the applicable out-of-network allowed amount or other rate, including the location in which the covered health care service or supply will be sought or provided; and (3) refine and reorder search results based on geographic proximity of network providers and the amount of the enrollee's estimated cost-sharing liability for the covered health care service or supply if the search returns multiple results.