Sponsor
Mark Takano
Representative · D-CA
Representative · D-CA
Official title: To amend the Employee Retirement Income Security Act of 1974 to increase transparency of group health plan data, prevent discrimination, and for other purposes.
Introduced June 25, 2026 by Mark Takano · Last progress June 25, 2026
The bill increases plan transparency and strengthens participant remedies—potentially lowering costs and speeding relief—but does so at the expense of added privacy risks, substantial new compliance burdens, and heightened litigation and penalty exposure for providers, employers, and plan administrators.
Plan participants and beneficiaries nationwide gain the right to sue immediately (without exhausting internal remedies), obtain equitable relief to restore eligibility/enrollment/premiums, and recover statutory per-participant penalties, strengthening protections against discrimination or retaliation and speeding remedies.
Employers, plan sponsors and their members gain stronger audit and price-transparency tools because group health plans can access de-identified claims and encounter data and obtain pricing disclosure in value-based or capitated arrangements, enabling verification of contract compliance and better bargaining to lower costs.
Group health plans are empowered to select auditors and are protected from undue delays or excessive fees, making audits more timely and effective and improving plan oversight.
Employers, plan sponsors, administrators, and fiduciaries nationwide face increased litigation risk and higher compliance costs because participants can sue immediately and fiduciary definitions may change, raising legal defense expenses and the potential for higher premiums or disrupted plan operations.
Hospitals, providers, PBMs and TPAs will incur substantial new costs and administrative burdens to assemble, de-identify, attest to, and produce large datasets for audits; combined with stiff civil penalties for obstructing audits, this could cause financial strain and increase litigation.
The statutory per-participant penalty ($100 per day) can quickly accumulate even for minor or short-term errors, exposing employers and plan sponsors to large liabilities and raising fairness concerns for inadvertent or technical violations.
Based on analysis of 4 sections of legislative text.
Mandates audit access to de‑identified claims data in group health plan contracts, bans contract audit restrictions, adds penalties, anti‑retaliation protections, and alters an ERISA fiduciary definition.
Requires group health plan service contracts to give plans audit access to de-identified claims and encounter data, limits contract terms that block audits or delay disclosure, and creates civil penalties for violations. It also adds anti‑retaliation protections for participants who exercise data rights and modifies an ERISA fiduciary definition.