Federally Required Documents to Augment Your Health Insurance
Please familiarize yourself with the following documents that, under Federal Law, plan sponsors of group medical insurance plans are required to share.
The Federal “Transparency in Coverage” Rule, requires health insurers and group health plans, including self-funded clients, to provide cost-sharing data to consumers by way of Machine Readable Files. Machine-readable files must be published on a publicly available site based on the enforcement date of July 1, 2022, for plan years beginning on or after Jan. 1, 2022. These files provide pricing data for covered items and services based on in-network negotiated payment rates and historical out-of-network allowed amounts. A third machine-readable file for prescription* drug rates and historical costs has been delayed pending further guidance. Information in these files must be updated and published monthly.
Resources for Transparency in Coverage
Transparency in Coverage External FAQs (pdf)
Regulatory and Key Initiatives Summary (pdf)
Insurance Carrier Sites
To access the machine-readable files created and published by the following insurance carriers, please click the link to your carrier below: