Sales Audience: IU65, SG, Mid-Group, NLGP, Truli for Health, Minimum Premium Program (MPP)
Summary
As of July 1, 2022, insurers and group health plans must provide public access to two types of rate files
and update these files on a monthly basis. An update on this implementation is provided below.
Details
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
