Health Insurer’s and Group Health Plans Transparency in Coverage Rule

In 2020, the Federal Government finalized the “Transparency in Coverage” Rule, which requires health insurers and group health plans, including self-funded clients, to provide cost-sharing data to consumers. For self-funded plans, such as the Town of Otisco’s plan for its employees, this information is to be available via Machine-readable files for plan years beginning on or after January 1, 2022. These files provide pricing data for covered items and services based on in-network negotiated payment rates and historical out-of-network allowed amounts.

The machine-readable files are available free of charge. The user is not required to establish a user account, password, or other credentials and does not require the user to submit any personal identifying information such as a name, email address, or telephone number.

The Town of Otisco participates In the Onondaga County Municipal Employee Benefits Agreement (OCEBA), which is an arrangement among several municipal entities involved in self-insurance plans for their municipal employees.

Therefore, to access the Machine-readable files relative to the Town of Otisco’s self-funded plan, please go on the internet to the following link, and scroll down to the OCEBA Group Health Benefits file: transparency-in-coverage.uhc.com