The Transparency in Coverage Final Rules (and related sub-regulatory guidance (see Q&A-1 and 2)) require non-grandfathered group health plans to disclose on a public website information regarding: (1) the in-network provider rates for covered items and services (see “in-network-rates” in filename); and (2) the historical out-of-network allowed amounts and billed charges for covered items and services (see “allowed-amounts” in filename) in two separate machine-readable files (MRFs).  The files must, in part, also include plan option/coverage identifier information; billing codes to identify items and services for claims processing; and all applicable rates.

The MRFs for the benefit package options under the Midwest Public Risk  Employee Benefits Program.  are linked below: 

Please NOTE:  The files are extremely large and exceed internal limits for a number of networks. As a result, if you wish to access and/or download these publicly available files, please check with your employer to determine the internal limits of your system before clicking on the link. You may need to use a network or a computer that was not issued to you by your employer for that purpose. 

THE LINK WILL GO LIVE ON JULY 1, 2022