Health Coverage Benefits

Recently, the Federal government issued the Transparency in Coverage (TiC) Final Rule. Under this Rule, group health plans must create and publish machine-readable files (MRFs) that contain detailed pricing information including:

 

1.  Network negotiated rates for all items and services.

2.  Historical payments to, and billed from charges from, out-of-network providers.

 

The primary intent for releasing these cost data files is to provide opportunities for detailed research studies and data analysis, as well as offer third-party developers and innovators the ability to create private-sector solutions to help drive additional price comparison and consumerism in the health care market.

 

Group health plans are required to make these files available to the public from an open-access internet website effective July 1, 2022.  IAG has been working with Allied Benefits, the third party administrator of its health coverage plans, to comply with the TiC Final Rule.  Effective July 1, Allied Benefits will create and publish the MRFs for the medical plans that Allied Benefits administers for IAG.  (At this time, the pharmacy MRFs are delayed pending additional rulemaking.)  Allied Benefits will host the files on IAG’s behalf to a publicly accessible website at sapphiremrfhub.com and will update the files on the first of each month. 

 

To review any of the information:

 

1. Access the website, select “Self-Insured”

2. Type in “Individual Advocacy Group, Inc.”

 

The group and the specific data will be displayed for public review.