Publicly Available Machine-Readable Files
In accordance with the Transparency in Coverage Rule finalized by the Departments of Health and Human Services, Labor and the Treasury on November 12, 2020, group health plans are required to post publicly available machine-readable files that include in-network negotiated payment rates and historical out-of-network charges for covered items and services, including prescription drugs. In order to facilitate compliance with this rule by the group health plans for which Symetra Life Insurance Company provides claim administrative services, Symetra Life Insurance Company is publishing these files on behalf of customers provided that Symetra has access to such rates and has not been instructed otherwise by a client.
Rate Files
MultiPlan Network: MPI_MPI_innetworkrates.json
PHCS Network: MPI_PHCS_innetworkrates.json
Current Table of Contents: multiplan_phcs_networks_index.json
Allowed Amount File
Allowed Amount File: allowedamount.json
Table of Contents: multiplan_phcs_networks_index.json
Prescription Drug File: negotiated rates and historical net prices (Delayed pending updated guidance)
The contents of this document do not have the force and effect of law and are not meant to bind the public in any way, unless specifically incorporated into a contract. This document is intended only to provide clarity to the public regarding existing requirements under the law.