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Transparency in Coverage
On November 12, 2020, the Departments of Health and Human Services, Labor and the Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to disclose certain pricing information.
Beginning July 1, 2022, group health plans and issuers of group or individual health insurance must post pricing information for covered items and services. This pricing information can be used by third parties, such as researchers and app developers to help consumers better understand the costs associated with their health care.
The files linked to below are machine readable files. Our pricing tool, per regulations, will be live in 2023.
- Table of Contents
- In-Network Pricing Information
- Out-of-Network Pricing Information - Commercial Group Plans
- Out-of-Network Pricing Information - Self-Funded Plans
Note - The files are very large, which may cause issues when downloading them. If you are experiencing problems, please try a different web browser or check your Internet/Wi-Fi speed.
More requirements will go into effect starting on January 1, 2023, and January 1, 2024 which will provide additional access to pricing information and enhance consumers' ability to shop for the health care that best meet their needs.
For more information about Transparency In Coverage, visit the CMS website at cms.gov/healthplan-price-transparency.
