Transparency in Coverage

The below links* lead to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule effective July 1, 2022 and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files (MRF) are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.  They are not meant for a member-friendly search of rates, benefits or cost sharing.  Members should continue to refer to the member resources available through anthem.com or capbluecross.com. 

As a reminder, under the Transparency in Coverage Rule issued in 2020 by the U.S. Department of Health & Human Services, U.S. Department of Labor and U.S. Department of the Treasury and enforced beginning 7/1/22, health plans (which includes clients who sponsor employee benefit plans) and health insurance issuers must publish two separate MRFs:

• In Network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers; and
• Out of Network: Allowed amount paid to and billed charges from out-of-network providers for all covered services within a 90-day period.

*Note that prior to 7/1/2022, the link will take you to either the Anthem or Capital Blue Cross home page but will access the MRFs page after that date.

Annual Required Notices

This centralized location has been created to ensure easy access to important Annual Required Notices and disclosures that are required to be distributed regularly. Here, you’ll find up-to-date information regarding those specific benefits, compliance, and employee rights, helping you stay informed and aligned with company policies and regulatory requirements. We encourage you to review these documents regularly.