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Transparency in Coverage

The Transparency in Coverage Ruling was issued in October of 2020 by the HHS, DOL, and Department of the Treasury. This rule requires group health plans (both fully insured and self-insured) to disclose information regarding in-network and out-of-network allowed amounts for billed services via machine-readable files. The MRF’s are to be used by Centers of Medicare and Medicaid Services or other third parties, to guide patients to more cost-effective health care services before patients receive care. MRFs include files that provide information on (1) in-network rates, (2) out-of-network historical rates, and (3) prescription drugs. 

MRF File Link: healthplan price transparency

 

The data inside the MRF link won’t be viewable until July 1, according to Aetna.  This data associated with the link will be updated by Aetna monthly.