Medical Group Benefits Transparency in Coverage

Transparency in Coverage Rule

Some Sutter Health medical groups administer self-funded healthcare plans as part of benefits programs offered to medical group employees. As required by the Transparency in Coverage Rule, machine-readable files that include negotiated rates for in-network services as well as the allowed amount for out-of-network services that are incurred under their respective health plans are available. These files are formatted to allow computer systems to import, manipulate and analyze the data.