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Transparency in coverage

Machine-readable files

This information is intended for third-party developers, researchers, government entities, employers and consultants.

The Transparency in Coverage rules from the U.S. Departments of Health and Human Services, Labor and Treasury requires health insurance companies providing coverage in the individual and group markets and group health plans to publicly disclose price information for covered items and services.

Please note:

  • The files contained in the Table of Contents are very large and in a JSON file format that’s impractical for direct consumer use. The goal of the Transparency in Coverage rules is to give researchers and third-party developers the comprehensive data they need to create solutions that help people understand the costs associated with health care, make better price comparisons and choose the care that’s right for them.

In-network provider-negotiated payment rates between plans and providers

These files include applicable in-network rates for certain UCare networks, including rates from contracted network partners. Posted rates include negotiated rates, claims-derived amounts for providers who are reimbursed on a discount from billed charges and underlying fee schedule rates where reimbursement is based on another methodology.

Machine-readable files

The machine-readable files contained in the Table of Contents file below are made available in response to the Federal Transparency in Coverage rules and include negotiated rates and out-of-network allowed amounts between health plans and health care providers.

Table of Contents