Transparency

Blackhawk and the Transparency in Coverage Rule Act: An Overview. As your health plan administrator, Blackhawk Claims Service will lead your organization through the Transparency in Coverage Rule Act

• What is the Transparency in Coverage Rule Act?
  • The Transparency in Coverage Rule Act requires health insurance issuers and group health plans to make information publicly available so consumers can make informed decisions regarding their healthcare.
• How can I access the information?
  • Information detailing the costs of in-network rates, out-of-network allowed amounts, and billed charges will be made available through Machine Readable Files (MRFs). Please note that MRFs are extremely large files and not user friendly.
• Blackhawk will publish MRFs to its website monthly.
  • Please note:
    • Fully Insured Plans: Employers with fully insured plans can expect the insurance carrier to satisfy the act.
    • Self-Insured Plans: Employers with self-insured plans should expect to post a publicly available link on their company website to satisfy the act.
  • For your convenience, here is a copy of the Transparency in Coverage Rule Act: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/CMS-Transparency-in-Coverage-9915F.pdf