For plan years beginning Jan. 1, 2022, the federal Transparency in Coverage Final Rule requires employer-sponsored group health benefit plans to disclose information in machine-readable files on a public website and to update them monthly. Files are required for in-network rates and out-of-network allowed amounts and billed amounts. This requirement becomes effective July 1, 2022.

Why are the files needed?
The data in the files will 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 healthcare market, according to the rule’s Fact Sheet.

How will we help?
We will provide a link to the table of contents for the machine-readable files to employers that offer a self-funded health benefit plan administered by Star Marketing and Administration, Inc.

What about machine-readable files on prescription drug costs?
Implementation of prescription-drug machine-readable files has been delayed indefinitely, pending additional guidance from the federal government.

For more information on federal mandates, visit this page.