Transparency

Nations and the Transparency in Coverage Rule Act: An Overview. As your health plan administrator, Nations Health Administrators Inc. will lead your organization through the Transparency in Coverage Rule Act.

What is the Transparency in Coverage Rule Act?

The Transparency in Coverage Rule Act requires health insurance issuers and group health plans to make information publicly available so consumers can make informed decisions regarding their healthcare.

How can I access the information?

Information detailing the costs of in-network rates, out-of-network allowed amounts, and billed charges will be made available through Machine Readable Files (MRFs). Please note that MRFs are extremely large files and are not user friendly.

Nations will publish MRFs to its website monthly.

Please note:

Fully Insured Plans: Employers with fully insured plans can expect the insurance carrier to satisfy the act.
Self-Insured Plans: Employers with self-insured plans should expect to post a publicly available link on their company website to satisfy the act.

For your convenience, here is a copy of the Transparency in Coverage Rule Act:
https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/CMS-Transparency-in-Coverage-9915F.pdf