# Hidden Fee Disclosure Act of 2025: What You Need to Know

If you get health insurance through your employer, this bill is about making sure your company knows exactly what it's paying for that coverage—and what hidden fees might be eating into your benefits. Right now, companies often don't get a clear picture of all the money flowing behind the scenes to the companies managing their health plans. This bill aims to change that by requiring much more detailed disclosure of fees and payments.

The bill focuses on two main types of companies that manage employer health plans: pharmacy benefit managers (PBMs) who handle prescription drug coverage, and third-party administrators who process medical claims and manage provider networks. These companies often make money in ways that aren't obvious—through rebates from drug manufacturers, discounts they negotiate but don't pass along, or fees they collect from multiple sources. Under current rules, employers might only get a vague summary of these payments. This bill requires these companies to spell out exactly where every dollar comes from and where it goes, including rebates from drug makers, discounts they keep for themselves, money they make from owning pharmacies, and fees they collect from other service providers.

The practical effect is that employers will get a detailed annual report showing all direct and indirect compensation these companies receive. For pharmacy managers, this includes specifics about drug rebates, the difference between what they pay pharmacies and what they charge the plan (called "spread pricing"), and any money they make from administering rebates. For claims administrators, it means disclosing all the money they collect from providers, other vendors, and through recovery efforts like catching overpayments. The goal is to help employers determine whether they're getting a fair deal and whether conflicts of interest exist—like a pharmacy manager steering patients to pharmacies it owns.

The bill takes effect on January 1, 2026, and applies to new contracts or renewals made after that date. It also includes privacy protections to ensure that sensitive health information disclosed in these reports stays confidential and follows existing healthcare privacy laws. Ultimately, this is about transparency: giving employers the information they need to negotiate better deals and potentially lower costs, which could eventually benefit employees through better benefits or lower premiums.