Transparency in Coverage

On October 29, 2020, the Departments of Treasury, Health and Human Services and Labor (Departments) released the Transparency in Coverage Final Rule and accompanying fact sheet , which outlines requirements for most employer-based group health plans and insurers to disclose price and cost-sharing information to consumers up front.

Currently, plans like GeoBlue must make available to the public two machine-readable files of pricing information: 1. the in-network negotiated rates with their providers; 2. the historical payments to out-of-network providers and their billed charges. These files must follow a standardized format and be regularly updated (monthly). As additional TCR requirements come into effect, web-based cost-comparison tools for consumers will be available beginning in 2023.

Learn more about Transparency in Coverage at GeoBlue.

Transparency in Coverage Files

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Note: The information displayed in the files represents the rate Blue Cross Blue Shield Licensees have negotiated with their in-network providers for all covered items and services and historically billed and allowed amounts for out-of-network services. This is not, however, an estimate of the cost patients will be responsible for paying for such items or service. Individual costs will vary depending upon the terms of the individual's specific health insurance coverage and the structure of the reimbursement arrangement, if applicable. Blue Cross and Blue Shield Licensees have made reasonable efforts to ensure that the data displayed in the files is complete and accurate at the time it is published. The data is refreshed each month.