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The Center for Independent Living Western Wisconsin

Transparency in Coverage Final Rules (“TiC Final Rules”) require, among other things, non-grandfathered group health plans and health insurance issuers offering health insurance in the individual and group markets to make available to the public (including stakeholders such as consumers, researchers, employers and third-party developers) three separate machine-readable files including detailed pricing information related to (1) negotiated rates for all covered items and services between the plan or issuer and in-network providers, (2) historical payments to, and billed charges from, OON providers (a minimum of 20 entries must be available to ensure privacy) and (3) the in-network negotiated rates and historical net prices for all covered prescription drugs by plan or issuer at the pharmacy location level.

Beginning July 1, 2022, Security Health Plan will begin posting pricing information for covered items and services on our website as part of compliance with the Centers for Medicare and Medicaid Services (CMS) and the Departments of Labor and the Department of the Treasury’s Transparency in Coverage Final Rule (CMS- 9915 –P), part of the No Surprises Act. This pricing information helps consumers better understand the costs associated with health care services.

To meet compliance requirements, Security Health is posting this pricing information as machine-readable (JSON format) files on their website at the following URL: https://www.securityhealth.org/insurance-resources/json.

Action: Link to the Security Health Transparency webpage (Security Health Transparency Webpage).


Link to the legal alert with additional information: Legal Alert