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Every year by December 31, group health plans must file a Gag Clause Prohibition Compliance Attestation (GCPCA) with the Centers for Medicare & Medicaid Services (CMS). This year marks the fourth annual filing. If your client’s plan is fully insured, the carrier handles the filing.

The requirement applies to medical plans only. Standalone dental and vision plans, health Flexible Spending Accounts (FSAs), employee assistance programs (EAPs), and Health Reimbursement Arrangements (HRAs) do not file.

What’s a Gag Clause?

A gag clause is contract language that keeps a health plan from sharing information about what it pays providers, or the quality of care that providers deliver. The Consolidated Appropriations Act of 2021 (CAA) banned these clauses in contracts between health plans and providers, networks, and the vendors that give plans access to them. Every year, plans must formally confirm that their contracts do not contain prohibited gag clauses.

Fully Insured Plans

The employer isn’t involved in provider contracting. The carrier is. The carrier files the attestation, and that filing covers both the carrier and the employer’s plan. Carriers are required to file and have done so every year since the first filing in 2023. Employers don’t need to file anything themselves, but it’s good for them to know the attestation is happening on their behalf.

Self-funded Plans

The plan itself is responsible for the attestation. Most self-funded employers don’t contract with providers directly. They use a carrier network through an administrative services only (ASO) arrangement or a third-party administrator (TPA). The practical step is to check in with the ASO or TPA now. Some file on the employer’s behalf. Others send a compliance letter so the employer can file. Either way, the employer should confirm it gets done. Employers filing on their own will need to register in CMS’s Health Insurance Oversight System (HIOS) first, so it’s worth starting before December.

Level-funded plans

These plans also carry the filing responsibility, but they use the carrier’s network, and the carrier typically handles the attestation or tells the group what’s needed. A quick confirmation with the carrier is all it takes.

Why the Rule Matters

The CAA’s goal is to make health care costs clearer for the people paying for and receiving care, through price comparison tools, cost estimates, and published rate data. None of that works if contracts block plans from sharing the numbers.

Four years in, the filing itself has become routine. The bigger work of turning open pricing into tools people actually use is still unfolding. Removing gag clauses was the step that made it possible, and each year’s attestation keeps that foundation in place. Over time, it may also give employers a clearer view of their own plan’s data.