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Transparency in Coverage

Transparency in Coverage Rule (CMS-9915-F)

The Transparency in Coverage Rule (CMS-9915-F), released on October 29, 2020, by the Department of Health and Human Services, requires group health plans to publicly disclose pricing information via an internet-based self-service tool. This tool includes information regarding negotiated rates for in-network providers, billed charges, and allowed amounts paid for out-of-network providers.

Click here to access the self-service tool.

You will be redirected to the Meritain Health website, where you will find machine-readable files corresponding to our plan. These files are intended for use with an associated computer program, not as a consumer tool. Plan members are encouraged to use the more member-friendly price estimator tool available through the Meritain Health public website.

The data in these files will be updated monthly. Multiple files may appear based on our plan offerings, network rates, and allowed amounts.

Additional information on the Transparency in Coverage Rule can be found on the Centers for Medicare & Medicare Services website.