Transparency in Coverage Rule

Employee Insurance

The Affordable Care Act and the Consolidated Appropriations Act require “transparency in coverage” cost-sharing disclosures by most health plans. To this end, regulations issued jointly by the Internal Revenue Service, Department of Labor, and the department of Health and Human Services require most health plans to disclose in-network provider negotiated rates, historical out-of-network allowed amounts for providers, and in-network negotiated rates and historical net prices for all covered prescription drugs at the pharmacy-location level. These disclosures must be made through three “machine-readable files” posted on a public internet website to help you to understand health care pricing. The below link to United Health Care website includes the required information.
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