Transparency in Coverage Final Rules – Machine Readable Files
Transparency in Coverage (TIC) Final Rules require Gusto, as the plan sponsor of its group health plan for its employees, to post in- and out-of-network pricing information to a public website. It requires plans to make available to the public separate machine-readable files that include detailed negotiated prices related to:
- In-network provider negotiated rates for covered items and services;
- Historical out-of-network allowed amounts and associated billed charges for covered items and services
Starting July 1, 2022, the medical plan vendors will post and update this information on a monthly basis. The machine-readable files are formatted to allow researchers, regulators, consumer advocates, and application developers to more easily access and analyze data. These files can be accessed in the links below.
In-network
https://www.anthem.com/ca/machine-readable-file/search
Search Gusto EIN: 453942850
Out-of-Network
https://transparency-in-coverage.collectivehealth.com/allowed-amount-meta.txt
Search “Gusto” or EIN: 453942850 for most-up-to-date links to files
For Gusto employees enrolled in the medical plan, log into your account at Collective Health to view your benefits.