HEALTH PLAN PRICING - TRANSPARENCY IN COVERAGE


Transparency in Coverage (TIC) regulations require health insurers and group health plans to (i) create machine readable files (MRFs) that contain (a) the negotiated service rates for in-network providers and (b) allowed amounts derived from historical claims for out-of-network providers AND (ii) make those files publicly available.

A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention. These files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

The following link leads to the machine readable files that are being made available in response to the TIC regulations: https://transparency-in-coverage.uhc.com