The Transparency in Coverage Disclosure provides members important information to help them ensure their services will be covered as outlined in their insurance plan and to help them understand their costs. You can view the Transparency in Coverage Disclosure by clicking the button below.
In 2020, the federal government created new regulations that require health insurers and group health plans to provide cost-sharing data to consumers. This is called the “Transparency in Coverage” rule. These new requirements offer consumers tools to better understand their healthcare costs.
We are meeting the requirements of the Transparency in Coverage Rule and upholding our value of putting our members first by making health care costs available to consumers.
Machine-Readable Files (MRF)
These files provide pricing data for covered items and services. CGHC began posting machine-readable files publicly on the website starting on July 1, 2022, and we update these files monthly.
The Transparency in Coverage Rule requires three types of Machine-Readable Files:
IMPORTANT – Machine-Readable Files are the first step in making this information more available to consumers. However, these files are not consumer-friendly. They require specialized software to open and view the data and are designed for use by researchers, regulators, and application developers. CGHC doesn’t provide or support any software needed to view these files. To view the Machine-Readable Files, please use the MRF links above.
Price Transparency Tool
CGHC provides members with access to cost estimates for 500 shoppable services. Member can access this searchable tool by logging into the My Health Portal. For the most accurate cost estimate, we recommend you contact your provider’s office and/or the facility where the service(s) will be performed. Your provider and/or facility will know all the services that might be billed. They can provide information beyond the 500 shoppable services available in the tool.
In 2020, the Interoperability and Patient Access Rule was created to make health care data more available to consumers. CGHC is happy to provide members with easy access to their healthcare data that we maintain via either a web portal or a mobile app of the member’s choosing. Before enrolling in this service, CGHC recommends you learn more about Protecting your Data and Selecting an App.
To utilize this feature of your coverage you will need to:
If you are a developer and would like more information on working with CGHC’s Interoperability APIs please check our Developer Portal.
If you have any questions or need additional assistance, please contact us!