Transparency in Coverage Final Rule Compliance

The Town of Wallingford Health Plan (the Plan) is required to provide certain information on a public website pursuant to the Transparency in Coverage Final Rule (Rule). 

The Rule is intended to make health care pricing information available to the general public, particularly researchers. These experts can use pricing information from this Plan and other plans to better understand the health care system and its costs and, hopefully, create new policies that improve competition and lower health care spending. 

The Rule requires that the Plan post links to machine-readable files that contain information about the price of health care services. A machine-readable file is written in computer code and is an extremely large file. It is not intended to be downloaded or read by participants but to be used in research studies. The files do not contain Protected Health Information (PHI) about you or your family.

Links on this website provide machine-readable files for the Plan’s in-network negotiated rates and historical allowed amounts for out-of-network charges. The files attached to the links are maintained by the Plan’s third-party administrator, Anthem. The files will be updated automatically each month by the third-party administrator. 

In 2023, the Plan will post additional price comparison information intended to allow participants and dependents to see health prices and shop for certain services. Stay tuned for additional information. 

If you have any questions about the Rule, you can read more information at https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f