Bridgera LLC provides this Transparency in Coverage disclosure page in accordance with the requirements set forth by the Centers for Medicare and Medicaid Services (CMS) under the Transparency in Coverage Final Rule (85 FR 72158).
The TiC Rule was designed to increase price transparency in healthcare, enabling consumers to access detailed cost-sharing information before receiving care, and giving employers and health plan sponsors the tools to make more informed decisions about benefits.
The Transparency in Coverage (TiC) Rule, published jointly by the Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury, requires non-grandfathered group health plans and health insurance issuers offering individual or group coverage to:
- Disclose in-network provider negotiated rates for covered items and services
- Disclose out-of-network allowed amounts and billed charges for covered items and services
- Disclose in-network negotiated rates and historical net prices for covered prescription drugs
- Make this information available in a standardized, machine-readable format
The TiC Rule requires covered health plans to make machine-readable files (MRFs) publicly available containing the following:
- In-Network Rate Files: Negotiated rates between the plan and in-network providers for covered items and services
- Allowed Amount Files: Historical payments to out-of-network providers and billed charges
- Prescription Drug Files: In-network negotiated rates and historical net prices for covered prescription drugs (applicable plans)
These files are updated monthly and made available in JSON format in accordance with CMS technical specifications.
The machine-readable files for Bridgera LLC’s group health plan are made available through our health insurance carrier or third-party administrator (TPA) in accordance with the TiC Rule requirements.
If you are a plan participant seeking to access these files, or if you require further information about Bridgera’s health plan coverage, please contact our HR department using the information below. Our health plan administrator can direct you to the appropriate MRF access point.
Machine-readable files for health plans may be large and are intended for programmatic access rather than direct consumer reading. The information contained in these files is technical pricing data and may require specialized tools to interpret.
For questions about Bridgera’s Transparency in Coverage compliance, health plan benefits, or to obtain assistance accessing machine-readable files, please contact our HR team using the information above.
For additional information about the Transparency in Coverage Rule, please visit the CMS website at cms.gov/healthplan-transparency.
Bridgera LLC — Talent Acquisition
500 W Peace St, Raleigh, NC 27603, United States
Email: info@bridgera.com
Phone: +1 919-230-9951