Transparency in Coverage

In compliance with The Transparency in Coverage Rule, issued in 2020 and effective July 1, 2022, health plans and health insurance issuers must publish Machine-Readable Files (MRFs) containing claims pricing details. Planstin Administration is pleased to provide the following information to participants.

The Transparency in Coverage Rule requires most health insurance issuers and group health plans to disclose pricing and cost-sharing information to participants, enrollees, and beneficiaries. Pricing information includes billed charges, negotiated rates, allowed amounts paid to providers, and the negotiated rate and historical net price for prescription drugs using two Machine-Readable Files (MRFs).

The MRFs are formatted to allow researchers, participants, regulators, and application developers to access and analyze data easily.

We are happy to continue to be part of the healthcare evolution, and happy to answer any questions you have regarding our MRFs.