Gag Clauses

  1. Prohibitions on benchmarking and comingling claims data from multiple companies
  2. Prohibitions on using data to develop or use any type of price transparency tool
  3. Prohibitions on using claims data to create any type of health care comparison data base
  4. Prohibitions on using claims data to do any cross-carrier comparisons
  5. Prohibitions on using claims data to run any type of RFP or RFI process to shop carrier
  6. Prohibitions on using claims data to contract with business coalitions, accountable care
    organizations, or centers of excellence
  7. Prohibitions on using data to “steer” members between providers of the same service
    type or category
  8. Prohibitions on performing certain analytical procedures on claims data, includes
    reverse engineering of pricing, margins, etc.
  9. Prohibitions on disclosure of claims data to any employees who are involved in provider
    network development or negotiating pricing and terms on behalf of any coalition or
  10. Upon terminating a carrier, prohibitions on maintaining the Company’s own historical
    claims data or sharing historical claims data with the Company’s new carrier.
  11. Limitations on carrier’s sharing of mental health or substance abuse data

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