06/08/2022
Machine-readable files required on public sites by July 1, 2022, for Transparency in Coverage
As the initial enforcement date of July 1, 2022, approaches for posting the machine-readable files (MRF) under the Transparency in Coverage Rule, UnitedHealthcare is providing an overview of requirements for health insurers and group health plans, including self-funded, UnitedHealthcare Level Funded, Oxford Level Funded and All Savers Alternate Funding clients.
UnitedHealthcare is committed to supporting the Transparency in Coverage Rule by making MRFs available for UnitedHealthcare self-funded and level funded customers on July 1, 2022.
Self-funded and level funded plans are required to make the MRFs publicly accessible. This requires providing a link to MRFs prepared by the insurer/TPA.
To meet this requirement, MRFs will be posted monthly on transparency-in-coverage.uhc.com. This location is publicly available and accessible to all — no authentication is required.
While these files are accessible to all, the file itself is large, written in JSON — a machine-readable language — and not easily interpreted or searchable.
MRF for self-funded and level funded plans
To comply with the Transparency in Coverage Rule, self-funded and level funded customers must post the transparency-in-coverage.uhc.com link on a publicly available website.
Important considerations and next steps
• When the UnitedHealthcare MRF link is posted, it must be easily accessible without a login/password.
• Prior to July 1, 2022, the UnitedHealthcare transparency in coverage website will display sample fully insured data. Company-specific information will not be displayed until July 1. Beginning July 1, the website will contain live data and MRFs in accordance with the requirements.
• Brokers and employers should work with applicable teams prior to July 1 to ensure the transparency in coverage website is publicly accessible by the required date.
• Brokers and employers may use the following language when posting the UnitedHealthcare transparency in coverage link:
o To access the machine-readable files created and published by UnitedHealthcare, please click here.
• Once the link is posted to a publicly available site, the employer responsibility is complete.
• Beginning July 1, 2022, employers may locate and view their MRF information. To do so:
o Go to transparency-in-coverage.uhc.com
o Search for the intended employer name
o Associated MRFs will appear
Example: 2022-07-01_customer name_Choice-Plus_in-network-rates.json
• MRFs will be updated monthly in accordance with requirements
Transparency in Coverage regulation requires self-funded employers to publish the link on a public site. If a self-funded group does not have a publicly available website, please discuss available options with legal counsel. UnitedHealthcare does not provide legal advice.
MRFs are not the member-friendly consumer price transparency tool that will be available in 2023 and 2024.
For more information, please refer to the frequently updated Transparency in Coverage FAQs and Transparency in Coverage website.
“To access the machine-readable files created and published by UnitedHealthcare, please click here.”