Gag Clauses Are “Banned”… So Why Can’t You Access Your Data? | What Employers Need to Know

Transcript

Gag clauses were officially banned under the Consolidated Appropriations Act (CAA)… so why are employers still struggling to access their own healthcare data?

In this episode of The EOB Podcast, Justin Leader and Julie Selesnick break down the real story behind gag clauses — what they are, why they were prohibited, and how they’re still impacting employers today.

While plan sponsors are now required to submit annual gag clause attestations confirming they have access to their data, many are finding that access is still limited, delayed, or controlled through internal “company policies” rather than explicit contract language.

This episode covers:

• What gag clauses actually are in healthcare contracts
• Why they were banned under the CAA
• How carriers and PBMs have adapted post-ban
• The challenges employers face when requesting claims and pricing data
• What the gag clause attestation requires (and why it matters)
• How to think about fiduciary responsibility and data access
• Practical steps employers can take to improve transparency

If you’re an employer, HR leader, CFO, broker, consultant, or plan fiduciary, this episode will help you better understand your responsibilities — and why simply signing an attestation isn’t enough.

Because when it comes to healthcare benefits, you can’t manage what you can’t see.

Follow for more conversations breaking down healthcare benefits, ERISA compliance, PBM transparency, and the real financial mechanics behind employer-sponsored health plans.

This episode was shot on Dec 18th, 2025

Source: https://eobpodcast.com