US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149 149.530: Register the plan or issuer in the Federal IDR registry, report changes within 30 days and confirm the registration annually

Each self-insured group health plan, FEHB carrier and health insurance issuer subject to the Federal IDR process must register with the Federal IDR registry, by the later of 90 business days after the Departments announce the registry functionality or the date it begins offering coverage, supplying its legal name (and the sponsor's), plan type, States of offering or licensing, any opt-in to a specified State law or All-Payer Model Agreement, contact points for open negotiation and for IDR, HIOS identifier, EIN and plan number or FEHB contract numbers, and the further information the Secretary specifies for rate determination and fee collection. Changes must be reported within 30 calendar days and the registration confirmed in the fourth quarter of each year. A TPA may perform the registration but the plan remains liable and must require the TPA to delineate each plan it acts for. Added by the final rule published 4 June 2026.