Transparency in Coverage Resources
The Transparency in Coverage Final Rules (the TiC Final Rules) require non-grandfathered group health plans and health insurance issuers offering non-grandfathered coverage in the group and individual markets to disclose on a public website information regarding in-network provider rates for covered items and services, out-of-network allowed amounts and billed charges for covered items and services, and negotiated rates and historical net prices for covered prescription drugs in three separate machine-readable files.
Aetna Transparency in Coverage Machine-Readable File
UMR Transparency in Coverage Machine-Readable File
The TiC Final Rules require plans and issuers to make price comparison information available to participants, beneficiaries, and enrollees through an internet-based self-service tool and in paper form, upon request.
Aetna Transparency in Coverage Price Transparency Tool: Aetna Transparency in Coverage Price Transparency Tool can be found in your Aetna Health account. Once you have logged in, select Find Care and Pricing at the top of the screen to get started. If you have not created an account, register at Aetna.com.
UMR Transparency in Coverage Price Transparency Tool: UMR Transparency in Coverage Price Transparency Tool can be found in your UMR.com account. Once you have logged in, select Health cost estimator at the bottom of the page to get started. If you have not created an account, register at UMR.com.