Transparency in Coverage

What does the Transparency in Coverage rule require?

The Transparency in Coverage rule requires health insurers and group health plans, including plan sponsors, to provide cost-sharing data to consumers through machine-readable files and a price comparison tool.

Gravie supports our plan sponsors. 

Gravie is committed to helping our plan-sponsor clients navigate the Transparency in Coverage rules by partnering with a vendor to maintain machine-readable files and create a price comparison tool.

Machine Readable Files (MRFs)

Employer Responsibility: Create and post machine-readable files containing pricing information about covered items and services that are formatted to allow third parties to access and analyze the data.

How Gravie Helps: Plan sponsors no longer need to post the link on their own site because Gravie agrees to post the link on behalf of our plan sponsors. MRF links vary based on the effective date of the plan sponsor, please see below for the appropriate link: 

  • Plans with effective dates of September 1, 2022 or earlier: Gravie partnered with PreferredOne to support our plan sponsors in meeting their MRF requirement by July 1, 2022. These plans can find MRFs at the following link until their renewal date: https://www.preferredone.com/mrf/
  • Plans with effective dates of October 1, 2022 or later: MRFs are downloadable below. For more information, contact your Gravie account manager.
    • MRFs for plans on Aetna network are available here
    • MRFs for plans on Cigna network are available here
    • MRFs for plans on Cigna OAP network are available here
    • MRFs for plans on HPS network are available here
    • MRFs for out-of-network plans on Zelis network are available here

Price Comparison Tool

Employer Responsibility: Provide an internet-based price comparison tool (or paper version upon request) that allows individuals to estimate their cost-sharing responsibility for specific items or services from specific providers.

How Gravie Helps: Gravie gives your employees access to MyMedicalShopper—a digital tool that lets them compare costs before scheduling care. Members can easily access MyMedicalShopper through the Gravie member portal, the Gravie mobile app, or by calling the Gravie Care team for support.

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