Skip to content
  • People Solutions
      • Human Powered Approach

        We offer world-class expertise with trusted teams, purpose-built to help you meet your goals.

        Learn more
      • We are always looking for consultants to join our team

        Explore Consulting Careers
      • Technology Solutions
        • AI & Data Services
        • App Dev, Integrations & Test Automation
        • Cybersecurity
        • Enterprise Agility, Product & Program Management
        • Infrastructure & Cloud
      • Financial, Risk & Compliance, and Advisory Solutions
        • Accounting Advisory
        • Business Optimization & Program Management
        • Risk & Compliance
        • SOX Compliance & Internal Audit
        • Specialty Financial Applications
      • Clinical Solutions
        • Clinical Operations
        • Clinical Data Sciences
        • Quality & Regulatory Compliance
  • Inside Eliassen
      • About Us
      • Leadership
      • Internal Careers
      • Newsroom
      • Partnerships
      • Consultant Advocate Program
      • Locations
  • Frontline Insights
      • Blog
      • Case Studies
      • Webinars
      • Whitepapers
Let's Connect
Let's Connect

Transparency in Coverage
Rule Information

Eliassen Group is sharing this information regarding rate transparency and negotiated rates for medical services.

The Transparency in Coverage Rule issued by the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury gives consumers the tools needed to access pricing information through their health plans. As of July 1, 2022, most non-grandfathered group health plans or health insurance issuers offering non-grandfathered health insurance coverage in the individual and group markets will be required to make available to the public, including stakeholders such as consumers, researchers, employers, and third-party developers, three separate machine-readable files that include detailed pricing information.

The first file will show negotiated rates for all covered items and services between the plan or issuer and in-network providers. The second file will show both the historical payments to, and billed charges from, out-of-network providers. Historical payments must have a minimum of twenty entries in order to protect consumer privacy. And, finally, the third file will detail the in-network negotiated rates and historical net prices for all covered prescription drugs by plan or issuer at the pharmacy location level. Plans and issuers must display these data files in a standardized format and will provide monthly updates. These files are required to be made public for plan years that begin on or after January 1, 2022.

Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Eliassen Group.

To link to the Machine-Readable Files, please click on the following URL: transparency-in-coverage.uhc.com

55 Walkers Brook Drive, 6th Floor
Reading, MA 01867

  • People Solutions
    • Human Powered Approach
  • Frontline Insights
    • Blog
    • Case Studies
    • Whitepapers
  • Technology Solutions
    • AI & Data Services
    • App Dev, Integrations & Test Automation
    • Cybersecurity
    • Enterprise Agility, Product & Program Management
    • Infrastructure & Cloud
  • Financial, Risk & Compliance, and Advisory Solutions
    • Accounting Advisory
    • Business Optimization & Program Management
    • Risk & Compliance
    • SOX Compliance & Internal Audit
    • Specialty Financial Applications
  • Clinical Solutions
    • Clinical Operations
    • Clinical Data Sciences
    • Quality & Regulatory Compliance
  • Inside Eliassen
    • About Us
    • Leadership
    • Careers
    • Newsroom
    • Partnerships
    • Consultant Advocate Program
    • Locations
    • Consulting Careers

Copyright © 2025 Eliassen Group. All Rights Reserved.

  • Privacy Choices
  • Your Privacy Choices
  • Privacy Statement
  • Legal Notices
  • Transparency
  • Opt-Out