It’s crucial for health plans and plan sponsors to verify the accuracy and timeliness of benefit documents, such as Certificates of Coverage, Summary Plan Descriptions, and Evidence of Coverages, as they finalize annual changes to benefit plan designs.
Some plans have discovered during audits by a Department of Labor, CMS, or a Department of Insurance, that their Non-Quantitative Treatment Limitations (NQTL) comparative analysis documents were outdated or incorrect, leading to challenges in rectifying inaccuracies and minimizing impact on members. Such inaccuracies can cast doubt on a plan’s internal controls and integrity of all aspects, often resulting in the need to produce multiple additional deliverables, evidence, and samples for regulators during the audit process.
Through its NQTL projects with clients, ATTAC has identified numerous discrepancies in health plans’ and plan sponsors’ benefit documents, including narratives that have been in place for a long time. ATTAC has the expertise to assist plans in creating, updating, and auditing plan benefit documents. Contact us to learn how we can help your plan prepare for a Mental Health Parity NQTL audit and ensure compliance.