Transparency in Coverage (TIC) regulations require health insurers and group health plans to create machine readable files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers and make those files publicly available. They must be made available on an open access website effective July 1, 2022.
The links displayed below lead to the machine-readable files that are made available in response to these regulations and include negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The MRFs are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
In coordination with the Transparency in Coverage Rule, the machine readable files below include plan Allowed Amounts and In-Network Rates for covered items and services. A more user friendly tool is also available at myWellmark.com by selecting Find Costs upon login.
If you are interested in more information on the TIC regulations, we would direct you to the US Department of Labor’s Employee Benefits Security Administration website. Thank you.