UMR Transparency

UMR Transparency in Coverage Rule Link for Publicly Available Websites Update

As the initial enforcement date of July 1, 2022, approaches for posting the machine-readable files (MRF) under the Transparency in Coverage Rule, UMR is providing an overview of requirements for health insurers and group health plans, including self-funded clients. 

Through UnitedHealthcare, we are committed to supporting the Transparency in Coverage Rule by making MRFs available for our self-funded customers on July 1, 2022.

Self-funded plans are required to make the MRFs publicly accessible. This requires providing a link to MRFs prepared by the insurer/TPA.

To meet this requirement, MRFs will be posted monthly on transparency-in-coverage.uhc.com. This location is publicly available and accessible to all, and no authentication is required.

Beginning July 1 and monthly thereafter, the MRFs will appear on this site.

While these files are accessible to all, the file itself is large, written in JSON, which is a machine-readable language, and not easily interpreted or searchable.

Through UnitedHealthcare, UMR creates and publishes the Machine-Readable Files on behalf of [ add customer name.]

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

• Once the link is posted to a publicly available site, the employer responsibility is complete, since UnitedHealthcare/UMR will update the MRFs each month as required.
• Beginning July 1, 2022, an employer may locate and view their Machine-Readable File information. To do so:
  • Hit Ctrl-F on your keyboard to bring up a search bar.
  • Type in your employer name and the associated MRFs will appear.
  • Example:  2022-07-01_customer name_Choice-Plus_in-network-rates.json.
• Multiple files may appear. Select the ones with your company name and the information and area of interests (network rates, allowed amounts, etc.).
• Files will be updated monthly in accordance with the requirements.

Important: Please note that the Transparency in Coverage regulation requires self-funded employers to publish the link on a public site. Therefore, if a self-funded group does not have a publicly available website, we would recommend you discuss your options with your legal counsel. UMR does not provide legal advice.

Just a reminder, these MRFs are not the member-friendly consumer price transparency tool that will be available in 2023 and 2024. For more information, continue to refer to the Transparency In Coverage FAQs on umr.com which I have attached and are updated frequently.