Transparency in Coverage

The Transparency Rule is part of the consolidated appropriations act that was passed in December 2020 by the U.S. Department of Health & Human Services/U.S. Department of Labor /U.S. Department of the Treasury. This Transparency In Coverage Act requires non-grandfathered group health plans/health insurance issuers in the group market to make available to the public (consumers, researchers, and third-party developers) three separate machine-readable files that include detailed pricing information. These files follow the Centers for Medicare & Medicaid Services (CMS) defined layout and are in the CMS-approved format (JSON) and are not meant for a consumer-friendly search of rates, benefits, or cost-sharing.

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