The Transparency in Coverage (TiC Regulations) and certain provisions of the Consolidated Appropriations Act of 2021 (CAA) (collectively “transparency requirements”) impose certain new obligations on group health plans, health insurers and health care providers to improve transparency in the cost of health services.
The first deadline for employers relates to the Transparency in Coverage rules that apply to employer-sponsored group health plans. The rules require group plans to disclose their rates and other price information for all covered billable services. Those plan obligations are to be phased in over a three-year span.
Two of these requirements become effective July 1, 2022:
- Group health plans must make public a machine-readable file with in-network provider rates for covered items and services (“In-network Rate Disclosures);
- Group health plans must make public a machine-readable file with out-of-network allowed amounts and billed charges for certain covered items and services (“Out-of-network Rate Disclosures).
Helpful Tips and Info
Through our partnership with United Healthcare, UMR, and HealthSCOPE Benefits, beginning July 1, 2022 you can locate our plan’s Machine Readable Files at: https://transparency-in-coverage.uhc.com/
- To search for our files on the web page:
- Press Ctrl-F on your keyboard to bring up a search bar.
- Type in Ozinga and the associated MRFs will appear.
- Example: 2022-07-01_Ozinga _Choice-Plus_in-network-rates.json.
- Multiple files may appear. Select the ones with your company name and the information and area of interests (network rates, allowed amounts, etc.).
- Files will be updated monthly in accordance with the requirements.