In April 2026, the Center responded to a proposed rule from the Department of Labor that would require third-party vendors in the pharmacy benefits space, such as pharmacy benefit managers (PBMs), to disclose their compensation to self-insured employers with whom they are contracted. This proposal reflects an important step toward fulfilling full transparency across the healthcare system, and we encourage the Department to extend this proposed regulation to all third-party administrators (TPAs) and owners of the provider network administering medical benefits.

One of the Center’s major focus areas is equipping employers with the data they need to be more effective purchasers and managers of healthcare benefits for their employees. Currently, employers lack visibility into the compensation streams and incentives that often drive the billing and payment practices of TPAs, PBMs, and owners of the provider network—entities that possess and control a health plan’s pricing information and “rent” their provider network to a self-insured employer for a fee. This information asymmetry impedes employers from satisfying their fiduciary duties as healthcare purchasers under the Employee Retirement Income Security Act (ERISA).

Drawing on our work to advance transparency and the use of pricing information to empower employers, the Center offered recommendations aimed at equipping self-insured employers with the information they need to select and monitor their vendor partners more prudently and negotiate more effectively. Specifically, the Center recommended that the Department should:

• Extend compensation disclosure requirements to all service providers: The Department should expand these requirements beyond PBMs to include all service providers—such as TPAs and owners of provider networks—who contract with self-insured group health plans for the provision and administration of medical benefits. Fiduciary duties apply across the entire plan, not only to pharmacy benefits, and many vendors beyond PBMs control critical data that employers need to fulfill their obligations.
• Expand the scope of the regulation to increase employer access to claims data: Employers need transaction-level access to claims and pricing data across the full transaction chain in order to understand and control their own spending and their employees’ costs. The Department could also explore classifying claims data as “compensation” to increase disclosure and data-sharing and should clarify that the proposed information-sharing requirement in Section 7.4 applies to a plan’s pricing and health claims data under the Gag Clause Prohibition (i.e., ERISA section 724).
• Extend audit rights to all relevant service providers: The explicit audit protections articulated in this proposed rule should apply to all TPAs and owners of provider networks involved in the administration of medical benefits. The Department should also ensure employers gain access to complete and accurate claims data, which is necessary to conduct rigorous, independent audits to fulfill their fiduciary duties.