Submit all claims to: EDI Payer ID: 66701 Group Marketing Services, Inc. PO Box 21044 Eagan, MN  55121

Transparency in health care
What is the transparency ruling?

In October 2020, the federal government issued the "transparency in coverage" final rule. The rule imposes new transparency requirements on most group health plans and health insurers in the individual and group markets. The purpose of the requirements is to enable consumers to make informed health care purchasing decisions.

What does this mean for Group Marketing Services members?

The rule initially requires health plans and issuers, including Group Marketing Services, to disclose pricing information related to the individual and group markets.

This includes information related to:

  • Negotiated rates for items and services between Group Marketing Services and in-network providers
  • Historical payments to out-of-network providers based on plan type

In compliance with the ruling, Group Marketing Services will begin publicly posting files with the above information to Group Marketing Service's website in July 2022. We will continue to work directly with government officials to ensure we are meeting all requirements within this ruling as they are issued.

Following the initial rate and payment disclosure requirements, the rule also lays out additional self-service cost estimation service provisions beginning in 2023.

While Group Marketing Services has long been sensitive to customer transparency, this ruling will help spur further innovation in the cost estimation space, and provide consumers with additional opportunities to better understand the cost of their health care.

Download Machine Readable Files