Federal Transparency in Coverage Rule - Machine Readable Files

Under the Transparency in Coverage Rule, issued in 2020 by the U.S. Department of Health & Human Services, U.S. Department of Labor, and U.S. Department of the Treasury, health insurance issuers must publish two separate Machine Readable Files (MRF).

These links lead to the MRF files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

• Blue Cross Blue Shield

  To access the files, each account has a unique link to a webpage driven by the company's Employer Identification Number (EIN). This webpage is freely available without logging in to an account and can be accessed using the following format:

  Navigating to the website:

  • 1) Replace [1234567] with the organization's EIN, removing the "-"
  • - For example, if 12-3456789 is the original EIN, you should add 123456789 in the URL
  • 2) Type the URL into your browser and hit Enter. The screen will now display access to the files specific to the organization's account, representing all plans with active membership.
  • These files are compressed using .gzip format, which may require a tool for opening.
• Presbyterian Health Plan
• Cigna