The proposed bill, known as the Employer Health Plan Transparency Act, aims to enhance transparency and accountability in health insurance contracts involving regulated health plans. It establishes definitions for key terms and prohibits certain contract provisions that limit access to claims and encounter information, delay information requests, or penalize health plans for making compliant disclosures. Contracts that violate these provisions will be deemed void. Additionally, the bill mandates that health insurance issuers and covered service providers must provide information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and requires regulated health plans to comply with HIPAA privacy regulations when handling such information.

Furthermore, the bill outlines specific requirements for claims submissions, including adherence to established transaction standards and the provision of unmodified copies of claims data. It also mandates annual declarations from health insurance issuers and covered service providers to ensure compliance with the act, with penalties for violations including civil fines and potential actions against licenses. The Insurance Commissioner is granted authority to enforce these provisions, issue orders, and take corrective actions as necessary. The act is set to take effect on November 1, 2026.