IMPORTANT MESSAGE
Critical Information about Transparency in Coverage
Action required for 7/1/22 compliance
This communication is being sent to fully insured and self-funded Cigna medical clients with a standard machine-readable files hosting service.
On 3/14/22, we contacted you regarding the Machine Readable Files (MRFs) requirement of the Transparency in Coverage Rule. This communication outlines the next steps and key information needed for the 7/1/22 enforcement date.
As a reminder, under the Transparency in Coverage Rule, issued in 2020 by the U.S. Department of Health & Human Services, U.S. Department of Labor and U.S. Department of the Treasury and enforced beginning 7/1/22, health plans (which includes clients who sponsor employee benefit plans) and health insurance issuers must publish two separate MRFs.
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In Network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers
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Out of Network: Allowed amount paid to, and billed charges from, out-of-network providers for all covered services within a 90-day period
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