Transparency in Coverage Rule

The Transparency in Coverage final rules require non-grandfathered group health plans and health insurance issuers offering non-grandfathered coverage in the group and individual markets to disclose on a public website information regarding:

• In-network negotiated rates for covered items and services
• Out-of-network allowed amounts and billed charges for covered items and services 

As of July 1, 2022, these machine-readable files (MRFs) must be made “publicly available and accessible to any person free of charge and without conditions, such as establishment of a user account, password, or other credentials, or submission of personally identifiable information (PII) to access the file” and must be updated on a monthly basis.  The website where these MRFs will be housed is:

https://www.floridablue.com/members/tools-resources/transparency

The site will also include a Table of Contents file with specific details on how to identify the file that applies to a specific health plan.