Your right to transparent coverage.
April 10, 2024
Machine-Readable Files (MRFs)
In compliance with The Transparency in Coverage Rule (TiC), health plans and health insurance issuers must publish two Machine-Readable Files (MRFs) containing in-network and out-of-network details.
About Transparency in Coverage (TiC)
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, and allowed amounts paid for out-of-network providers using two Machine-Readable Files (MRFs).
Learn More
- To access the In-Network and Out-of-Network MFRs, visit planstin.com/transparency-in-coverage.
- Questions about your benefits? Contact a Benefit Advocate at 888-920-7526.
Explore
SUGGESTED READING
Most Planstin-managed health plans do not use a provider network . That means you are free to work with any provider with out fear of any out-of-network penalties. Very few Planstin-managed health plans still use a provider network. In this case, your health plan uses the PHCS network of providers. Fair-priced healthcare & care coordination The majority of Planstin-managed health plans use an innovative healthcare pricing strategy called fair-priced healthcare. This strategy does not require the use of a provider network, and instead relies on a care coordination team to help you work with your provider, make appointments, and locate providers that work well with your benefits. To learn more about fair-priced healthcare, click here . To learn more about care coordination click here .
Preventive Core is a health plan that focuses on preventive care. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive Core health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive Core health plan, click here and select your specific plan name.
All Planstin-managed health plans now feature care coordination services as a part of a fair-price healthcare strategy. The Planstin Care Coordination team will help match members with providers that work best with their plan.