The Transparency in Coverage final rule issued on October 29, 2020, requires most group health plans and health insurance issuers to provide public disclosures in machine-readable files regarding in-network, out-of-network and prescription drug prices. This health plan price transparency helps consumers know the cost of a covered item or service before receiving care. The information on this webpage was designed to comply with the Transparency in Coverage Final Rule requirements.
TRS-Care, TRS-ActiveCare and the administrator, Blue Cross Blue Shield of Texas (BCBSTX), share pricing information with the public through these machine-readable files.
As the claims administrator for TRS-Care and TRS-ActiveCare, BCBSTX generates the in-network and out-of-network files for TRS-Care and TRS-ActiveCare. The files are posted on the
BCBSTX website.
The
in-network file discloses negotiated rates between plans and providers for covered items and services. The
out-of-network (allowed amount) file discloses unique allowed amounts and billed charges for out-of-network services. Both files are significantly larger than average website downloads and must use compressed .gzip format. Download speeds may vary.
Note: The machine readable claim files are distinct from the claims data TRS makes available for employers that participate in TRS-ActiveCare. See
How to Get Claims Data for Your District for more information about claims data for employers to compare TRS-ActiveCare to other options in the market and make informed decisions about employee health benefits.
