Important Transparency in Coverage
Machine Readable File Information
Transparency in Coverage (TIC) regulations require health insurers and group health plans to create machine readable files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers and make those files publicly available. They must be made available on an open access website effective July 1, 2022.
If you are one of our self-funded groups, you have already received notice that we are publishing the machine-readable files on your behalf for the benefits we administer and maintain.
For our fully insured policyholders, this notice serves as our agreement to post the machine-readable files associated with your policy on your behalf.
A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention.
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. Please refer to the member resources available through anthem.com for this information.
Beginning July 1, Anthem will publish the MRFs for the plans we administer and maintain. These files will be published on anthem.com and will be updated on the first day of each month.
Click here to access the MRF link