This communication has been sent to all commercial group accounts

The Transparency in Coverage (TIC) Final Rule, issued in 2020, sets forth requirements for group health plans and health insurance issuers to produce machine-readable files (MRFs) disclosing in-network negotiated rates and historical out-of-network allowed amounts by July 1, 2022. In addition, plans and issuers are required to disclose cost-sharing information - including an estimate of an individual’s cost-sharing liability - for covered items or services furnished by a particular provider beginning on Jan. 1, 2023.

UPMC Health Plan will make MRFs - including in-network rates and out-of-network allowed amounts - available online for July 1, 2022, in accordance with the final rule and updated timelines issued by the departments of Labor, Treasury, and Health and Human Services.  In addition, UPMC Health Plan continues to make necessary updates to its cost estimator tool to ensure compliance with additional TIC requirements that take effect 1/1/2023 and 1/1/2024. 

We have created a detailed FAQ document that addresses a number of questions and issues related to the TIC Final Rule. Please contact your UPMC Health Plan account manager if you have any questions about UPMC Health Plan's compliance with TIC requirements.