I 
119TH CONGRESS 
1ST SESSION H. R. 2041 
To amend the Employee Retirement Income Security Act of 1974 to clarify 
and strengthen the application of certain employer-sponsored health plan 
disclosure requirements. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2025 
Mr. COURTNEY (for himself and Mrs. HOUCHIN) introduced the following bill; 
which was referred to the Committee on Education and Workforce 
A BILL 
To amend the Employee Retirement Income Security Act 
of 1974 to clarify and strengthen the application of 
certain employer-sponsored health plan disclosure re-
quirements. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Hidden Fee Disclosure 
Act of 2025’’. 
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SEC. 2. CLARIFICATION OF THE APPLICATION OF FEE DIS-
CLOSURE 
REQUIREMENTS 
TO 
COVERED 
SERVICE PROVIDERS. 
(a) 
SERVICES.—Clause 
(ii)(I)(bb) 
of 
section 
408(b)(2)(B) of the Employee Retirement Income Secu-
rity Act of 1974 (29 U.S.C. 1108(b)(2)(B)) is amended— 
(1) in subitem (AA) by striking ‘‘Brokerage 
services,’’ and inserting ‘‘Services (including broker-
age services),’’; and 
(2) in subitem (BB)— 
(A) by striking ‘‘Consulting,’’ and inserting 
‘‘Other services,’’; and 
(B) by striking ‘‘related to the development 
or implementation of plan design’’ and all that 
follows through the period at the end and in-
serting ‘‘any of the following: plan design, claim 
repricing, insurance or insurance product selec-
tion (including vision and dental), record-
keeping, medical management, benefits adminis-
tration selection (including vision and dental), 
stop-loss insurance, pharmacy benefit manage-
ment services, wellness design and management 
services, transparency tools, group purchasing 
organization agreements and services, participa-
tion in and services from preferred vendor pan-
els, disease management, compliance services, 
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employee assistance programs, or third party 
administration services, or consulting services 
related to any such services.’’. 
(b) DISCLOSURES.—Clause (iii)(III) of section 
408(b)(2)(B) of the Employee Retirement Income Secu-
rity Act of 1974 (29 U.S.C. 1108(b)(2)(B)) is amended 
by striking ‘‘, either in the aggregate or by service,’’ and 
inserting ‘‘by service’’. 
SEC. 3. STRENGTHENING DISCLOSURE REQUIREMENTS 
WITH RESPECT TO ENTITIES PROVIDING 
PHARMACY BENEFIT MANAGEMENT SERV-
ICES AND THIRD PARTY ADMINISTRATORS 
FOR GROUP HEALTH PLANS. 
(a) CERTAIN ARRANGEMENTS FOR PHARMACY BEN-
EFIT MANAGEMENT SERVICES CONSIDERED
AS INDI-
RECT.— 
(1) 
IN
GENERAL.—Clause 
(i) 
of 
section 
408(b)(2)(B) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1108(b)(2)(B)) is 
amended— 
(A) by striking ‘‘requirements of this 
clause’’ and inserting ‘‘requirements of this 
subparagraph’’; and 
(B) by adding at the end the following: 
‘‘For purposes of applying section 406(a)(1)(C) 
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with respect to a transaction described under 
this subparagraph, a contract or arrangement 
for services between a covered plan and an enti-
ty or subsidiary providing services to the plan, 
including a health insurance issuer providing 
health insurance coverage in connection with 
the covered plan in which the entity or sub-
sidiary contracts, in connection with such plan, 
with a service provider for pharmacy benefit 
management services shall be considered an in-
direct furnishing of goods, services, or facilities 
between the covered plan and the service pro-
vider for pharmacy benefit management services 
acting as the party in interest.’’. 
(2) HEALTH INSURANCE ISSUER AND HEALTH 
INSURANCE COVERAGE DEFINED.—Clause (ii)(I)(aa) 
of section 408(b)(2)(B) of the Employee Retirement 
Income 
Security 
Act 
of 
1974 
(29 
U.S.C. 
1108(b)(2)(B)) is amended by inserting before the 
period at the end ‘‘and the terms ‘health insurance 
coverage’ and ‘health insurance issuer’ have the 
meanings given such terms in section 733(b)’’. 
(3) 
TECHNICAL
AMENDMENT.—Section 
408(b)(2)(B)(ii)(I)(aa) of the Employee Retirement 
Income 
Security 
Act 
of 
1974 
(29 
U.S.C. 
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concessions, co-payment offsets, and other 
remuneration, including the amount ex-
pected to be passed through to the plan 
sponsor or the participants and bene-
ficiaries under the covered plan; 
‘‘(cc) all compensation reasonably ex-
pected to be received by the covered service 
provider, an affiliate, or a subcontractor as 
a result of paying a lower amount for the 
drug than the amount charged as a copay-
ment, coinsurance amount, or deductible; 
‘‘(dd) all compensation expected to be 
received by the covered service provider, an 
affiliate, or a subcontractor as a result of 
paying pharmacies less than the amount 
charged to the health plan, plan sponsor, 
or participants and beneficiaries (com-
monly referred to as ‘spread pricing’); 
‘‘(ee) all compensation expected to be 
received by the covered service provider, an 
affiliate, or a subcontractor from drug 
manufacturers or any other third party in 
exchange for— 
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‘‘(AA) administering, invoicing, 
allocating, or collecting rebates related 
to the covered plan; 
‘‘(BB) providing access to drug 
utilization data; 
‘‘(CC) retaining a percentage of 
the list price of a drug; or 
‘‘(DD) any other service related 
to the role of the covered service pro-
vider as a conduit between the drug 
manufacturers or any other third 
party and the covered plan.’’. 
(2) ANNUAL DISCLOSURE.—Clause (v) of sec-
tion 
408(b)(2)(B) 
of 
such 
Act 
(29 
U.S.C. 
1108(b)(2)(B)) is amended by adding at the end the 
following: 
‘‘(III) A covered service provider, with respect 
to a contract or arrangement with the covered plan 
in connection with providing pharmacy benefit man-
agement services, shall disclose, on an annual basis 
not later than 60 days after the beginning of each 
plan year, to a responsible plan fiduciary, in writing, 
the following with respect to the preceding plan 
year: 
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‘‘(aa) All direct compensation described in 
subclause (III) of clause (iii) and indirect com-
pensation described in subclause (IV) of clause 
(iii) received by the covered service provider (in-
cluding such compensation described in sub-
clause (VII) of clause (iii)). 
‘‘(bb) The total gross spending by the cov-
ered plan on drugs (excluding fees rebates, al-
ternative discounts, price concessions, co-pay-
ment offsets, and other remuneration). 
‘‘(cc) The total net spending by the cov-
ered plan on drugs. 
‘‘(dd) The total gross spending on drugs at 
all pharmacies wholly or partially owned by the 
covered service provider or any entity affiliated 
with the covered service provider, including 
mail-order, specialty and retail pharmacies, with 
a breakdown by individual pharmacy location. 
‘‘(ee) The aggregate amount of cost-shar-
ing collected by the covered service provider 
from a pharmacy for a participant or bene-
ficiary in excess of the contracted rate from 
such pharmacies, including mail-order, spe-
cialty, and retail pharmacies, including— 
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‘‘(AA) 
categorical 
explanations 
(grouped by the reason for collection of 
such amounts, such as contractual true-up 
provisions, overpayments, or non-covered 
medication dispensed, and including infor-
mation on the amount in each category 
that was passed through to the covered 
plan and to participants and beneficiaries 
of the covered plan); or 
‘‘(BB) individual explanations for 
such amounts. 
‘‘(ff) Total aggregate amounts of fees col-
lected by the covered service provider, an affil-
iate, or a subcontractor in connection with the 
provision of pharmacy benefit management 
services to the covered plan, broken down by 
the source of such fees (such as the covered 
plan, participants and beneficiaries of the cov-
ered plan, any drug manufacturer or whole-
saler, or any pharmacy entity). 
‘‘(gg) Any information specified by the 
Secretary through regulations or guidance that 
may be necessary for a responsible plan fidu-
ciary to determine the reasonableness of the 
contract or arrangement with the covered serv-
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ice provider, any compensation paid under such 
a contract or arrangement, or any conflicts of 
interest that may exist.’’. 
(3) PHARMACY BENEFIT MANAGEMENT SERV-
ICES
DEFINED.—Clause 
(ii)(I) 
of 
section 
408(b)(2)(B) of such Act (29 U.S.C. 1108(b)(2)(B)) 
is amended by adding at the end the following: 
‘‘(gg) The term ‘pharmacy benefit manage-
ment services’ includes any services provided by 
a covered service provider to a covered plan 
with respect to the administration of prescrip-
tion drug benefits under the covered plan, in-
cluding— 
‘‘(AA) the processing and payment of 
claims; 
‘‘(BB) design of pharmacy networks; 
‘‘(CC) negotiation, aggregation, and 
distribution of rebates, discounts, and 
other price concessions; 
‘‘(DD) formulary design and mainte-
nance; 
‘‘(EE) 
operation 
of 
pharmacies 
(whether retail, mail order, specialty drug, 
or otherwise); recordkeeping; 
‘‘(FF) utilization review; 
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‘‘(GG) adjudication of claims; and 
‘‘(HH) any other services specified by 
the Secretary through guidance or rule-
making.’’. 
(c) SPECIFIC DISCLOSURE REQUIREMENTS WITH 
RESPECT TO THIRD PARTY ADMINISTRATION SERVICES 
FOR GROUP HEALTH PLANS.— 
(1) IN
GENERAL.—Clause (iii) of section 
408(b)(2)(B) 
of 
such 
Act 
(29 
U.S.C. 
1108(b)(2)(B)), as amended by subsection (b)(1), is 
further amended by adding at the end the following: 
‘‘(VIII) With respect to a contract or ar-
rangement with the covered plan in connection 
with the provision of third party administration 
services for group health plans, as part of the 
description required under subclauses (III) and 
(IV)— 
‘‘(aa) the amount and form of any re-
bates, discounts, savings fees, refunds, or 
amounts received from providers and facili-
ties, including the amounts that will be re-
tained by the covered service provider; 
‘‘(bb) the amount and form of fees ex-
pected to be received from other service 
providers in relation to the covered plan, 
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including the amounts that will be retained 
by the covered service provider as a fee, to 
the extent feasible; and 
‘‘(cc) the amount and form of ex-
pected recoveries by the covered service 
provider, including the amounts that will 
be retained by the covered service provider 
(disaggregated by category), as a result 
of— 
‘‘(AA) overpayments; 
‘‘(BB) erroneous payments; 
‘‘(CC) uncashed checks or incom-
plete payments; 
‘‘(DD) billing errors; 
‘‘(EE) subrogation; 
‘‘(FF) fraud; or 
‘‘(GG) any other reason on behalf 
of the covered plan.’’. 
(2) ANNUAL DISCLOSURE.—Clause (v) of sec-
tion 
408(b)(2)(B) 
of 
such 
Act 
(29 
U.S.C. 
1108(b)(2)(B)), as amended by subsection (b)(2), is 
amended by adding at the end the following: 
‘‘(IV) A covered service provider, with respect 
to a contract or arrangement with the covered plan 
in connection with providing third party administra-
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tion services for group health plans, shall disclose, 
on an annual basis not later than 60 days after the 
beginning of each plan year, to a responsible plan fi-
duciary, in writing, the following with respect to the 
preceding plan year: 
‘‘(aa) All direct compensation described in 
subclause (III) of clause (iii). 
‘‘(bb) All indirect compensation described 
in subclause (IV) of clause (iii) received by the 
covered service provider, an affiliate, or a sub-
contractor (including such compensation de-
scribed in subclause (VIII) of clause (iii)). 
‘‘(cc) The aggregate amount for which the 
covered service provider, an affiliate, or a sub-
contractor received indirect compensation and 
the estimated amount of cost-sharing incurred 
by plan participants and beneficiaries as a re-
sult. 
‘‘(dd) The total gross spending by the cov-
ered plan on all costs and fees arising under or 
paid under the administrative services agree-
ment with the covered service provider (not in-
cluding any amounts described in items (aa) 
through (cc) of clause (iii)(VIII)). 
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‘‘(ee) The total net spending by the cov-
ered plan on all costs and fees arising under or 
paid under the administrative services agree-
ment with the covered service provider. 
‘‘(ff) The aggregate fees collected by the 
covered service provider, an affiliate, or a sub-
contractor from any source. 
‘‘(gg) Any other information specified by 
the Secretary through regulations or guidance 
that may be necessary for a responsible plan fi-
duciary to determine the reasonableness of the 
contract or arrangement with the covered serv-
ice provider any compensation paid under such 
a contractor or arrangement, or any conflicts of 
interest that may exist.’’. 
(3) THIRD PARTY ADMINISTRATION SERVICES 
FOR
GROUP
HEALTH
PLANS
DEFINED.—Clause 
(ii)(I) of section 408(b)(2)(B) of such Act (29 
U.S.C. 1108(b)(2)(B)), as amended by subsection 
(b)(3), is amended by adding at the end the fol-
lowing: 
‘‘(hh) The term ‘third party administration 
services for group health plans’ includes any 
services provided by a covered service provider 
to a covered plan with respect to the adminis-
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tration of health benefits under the covered 
plan, including— 
‘‘(AA) the processing, repricing, and 
payment of claims; 
‘‘(BB) design, creation, and mainte-
nance of provider networks; 
‘‘(CC) negotiation of discounts off 
gross rates; 
‘‘(DD) benefit and plan design; nego-
tiation of payment rates; 
‘‘(EE) recordkeeping; 
‘‘(FF) utilization review; 
‘‘(GG) adjudication of claims; 
‘‘(HH) regulatory compliance; and 
‘‘(II) any other services set forth in 
an administrative services agreement or 
similar agreement or specified by the Sec-
retary through guidance or rulemaking.’’. 
(d) PRIVACY REQUIREMENTS.—Section 408(b)(2) of 
the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1108(b)(2)), as amended by subsection (c), is 
further amended by adding at the end the following: 
‘‘(C) PRIVACY REQUIREMENTS.—Covered serv-
ice providers shall provide information under sub-
paragraph (B) in a manner consistent with the pri-
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vacy 
regulations 
promulgated 
under 
section 
13402(a) of the Health Information Technology for 
Clinical Health Act (42 U.S.C. 17932(a)), and con-
sistent with the privacy regulations promulgated 
under the Health Insurance Portability and Ac-
countability Act of 1996 in part 160 and subparts 
A and E of part 164 of title 45, Code of Federal 
Regulations (or successor regulations) and shall re-
strict the use and disclosure of such information ac-
cording to such privacy, security, and breach notifi-
cation regulations and such privacy regulations. 
‘‘(D) DISCLOSURE AND REDISCLOSURE.— 
‘‘(i) LIMITATION
TO
BUSINESS
ASSOCI-
ATES.—A responsible plan fiduciary receiving 
information disclosed under subparagraph (B) 
may disclose such information only to the entity 
from which the information was received, the 
group health plan to which the information per-
tains, or to that entity’s business associates as 
defined in section 160.103 of title 45, Code of 
Federal Regulations (or successor regulations) 
or as permitted by the HIPAA Privacy Rule 
(parts 160 and 164, subparts A and E of title 
45, Code of Federal Regulations). 
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‘‘(ii) CLARIFICATION
REGARDING
PUBLIC 
DISCLOSURE
OF
INFORMATION.—Nothing in 
this section shall prevent a group health plan or 
health insurance issuer offering group health 
insurance coverage, or a covered service pro-
vider, from placing reasonable restrictions on 
the public disclosure of the information de-
scribed in this subparagraph, except that such 
plan, issuer, or entity may not restrict disclo-
sure of such information to the Department of 
Labor. 
‘‘(E) ADDITIONAL PRIVACY REQUIREMENTS.— 
‘‘(i) IN
GENERAL.—Covered service pro-
viders shall ensure that information provided 
under subparagraph (B) contains only summary 
health information, as defined in section 
164.504(a) of title 45, Code of Federal Regula-
tions (or successor regulations). 
‘‘(ii) RESTRICTIONS.—A group health plan 
shall comply with section 164.504(f) of title 45, 
Code of Federal Regulations (or successor regu-
lations) with respect to any information re-
ceived by the plan or disclosed to a plan spon-
sor or any other entity pursuant to this section, 
and a responsible plan administrator who is a 
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plan sponsor shall act in accordance with the 
terms of the agreement described in such sec-
tion. 
‘‘(F) RULE
OF
CONSTRUCTION.—Nothing in 
this section shall be construed to modify the require-
ments for the creation, receipt, maintenance, or 
transmission of protected health information under 
the privacy regulations promulgated under the 
Health Insurance Portability and Accountability Act 
of 1996 in part 160 and subparts A and E of part 
164 of title 45, Code of Federal Regulations (or suc-
cessor regulations).’’. 
(e) RULE
OF
CONSTRUCTION.—Nothing in the 
amendments made by this section shall be construed to 
imply that a practice in relation to which a covered service 
provider is required to provide information as a result of 
such amendments is permissible under Federal law. 
(f) EFFECTIVE DATE.—The amendments made by 
this subsection shall not apply to any contract or arrange-
ment entered into prior to January 1, 2026. Such amend-
ments shall apply to any contract or arrangement entered 
into on or after to such date, including any extension or 
renewal of a contract or arrangement, regardless of the 
date on which the original contract or agreement (or any 
previous extension or renewal) was entered into. 
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SEC. 4. IMPLEMENTATION. 
Not later than 1 year after the date of enactment 
of this Act, the Secretary of Labor shall issue notice and 
comment rulemaking as necessary to implement the provi-
sions of this Act. The Secretary shall ensure that such 
rulemaking— 
(1) accounts for the varied compensation prac-
tices of covered service providers (as defined under 
section 408(b)(2)(B); and 
(2) establishes standards for the disclosure of 
expected compensation by such covered service pro-
viders. 
Æ 
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