Machine-Readable Files | Unified Health Plan

⚖️ Price Transparency · Machine-Readable Files

⚖️ Federal Transparency in Coverage — Public Disclosure

Health Plan Price Transparency
Machine-Readable Files

In accordance with the Transparency in Coverage Final Rules (29 CFR 2590.715-2715A2 and A3), Unified Health Plan publishes this index file on behalf of all self-funded employer health plans we administer. This page is publicly accessible, free of charge, with no login required.

📑

Table of Contents — Index File

Links all MRFs for every administered self-funded plan

Format JSON

Updated Monthly

Access Free · No login

↓ Download MRF Index File (JSON)

Contains links to In-Network Rate and Allowed Amount MRFs for all applicable plans.

⚖️ Federal Transparency in Coverage — Public Disclosure

First Health Network
Machine-Readable Files

In accordance with the Transparency in Coverage Final Rules (29 CFR 2590.715-2715A2 and A3), the following machine-readable files are made available for the First Health network. These files are publicly accessible, free of charge, and require no login.

These files are maintained by HealthPlan Services on behalf of the First Health network.

Access First Health Machine-Readable Files

About This Page

What You’re Accessing & Why It Exists

This page exists to meet a federal requirement. Here’s what that means in plain language.

📋

The Federal Requirement

The Transparency in Coverage Final Rules require non-grandfathered group health plans to publish health care pricing data in standardized machine-readable files — publicly, free of charge, with no access restrictions.

🏢

Our Role as TPA

Unified Health Plan administers health benefits on behalf of self-funded employers. Through written agreements with each plan sponsor, we publish and maintain these MRFs on their behalf — satisfying each plan’s federal disclosure obligation.

🔍

Who Uses These Files

MRFs are structured data feeds designed for software processing — not consumer reading. Researchers, developers, price comparison tools, and federal regulators use them to analyze health care pricing across plans and markets.

What’s Inside

Files Referenced in the Index

The index file links to the following MRF types for each applicable plan we administer.

● Active

In-Network Rate File

Negotiated rates between the health plan and all in-network providers for covered items and services. Includes provider NPIs, TINs, billing codes, and the applicable negotiated rate.

● Active

Allowed Amount File

Historical billed charges and allowed amounts paid to out-of-network providers. Published where a minimum of 20 claims exist per service line, to protect member privacy.

⧖ Pending

Prescription Drug File

Negotiated rates and historical net prices for covered Rx drugs. Enforcement deferred pending federal guidance. This file will be added to the index once the requirement activates.

📑

The index file above is a single JSON file listing every self-funded plan we administer, with direct URLs to each plan’s underlying MRF files. This structure is compliant with CMS technical implementation guidance published at github.com/CMSgov/price-transparency-guide.

Compliance Framework

How Compliance Works for Plan Sponsors

For employer clients and their advisors — a plain-language summary of who is responsible for what.

✅ What We Handle for You

Generate and publish the In-Network Rate MRF monthly
Generate and publish the Allowed Amount MRF monthly
Maintain this public page and the index file at a stable URL
Ensure JSON schema compliance per CMS technical guidance
Add new plans to the index file upon onboarding
Monitor regulatory updates and revise files as required
Publish the Rx Drug MRF once enforcement guidance is finalized
Provide each plan sponsor with this page URL for their records

⚠️ What Plan Sponsors Must Do

Confirm a written MRF agreement is in your service contract
If your organization has a public website, post a link to this page or the index file URL
Periodically verify this page and the index file remain accessible
Retain the written MRF agreement in your plan records
Understand that plan liability remains if the TPA fails to post
Contact your account manager with any compliance questions

Questions

Frequently Asked Questions

Answers for employers, members, brokers, and the public about MRF compliance and how Unified Health Plan fulfills these obligations.

General

A Machine-Readable File (MRF) is a structured digital data file — published in JSON format — containing health plan pricing information. Required under the federal Transparency in Coverage (TiC) rules, MRFs are designed to be processed by software applications, not read directly by consumers. They enable researchers, developers, price comparison tools, and federal regulators to analyze negotiated rates and historical payment data across health plans.

The Transparency in Coverage Final Rules (29 CFR 2590.715-2715A2 and A3), issued jointly by the Departments of Labor, Health & Human Services, and Treasury, require all non-grandfathered group health plans to publicly disclose health care pricing data in standardized MRFs. Enforcement of the In-Network Rate and Allowed Amount files began July 1, 2022.

The TiC rules require three files: (1) the In-Network Rate File — negotiated rates between the plan and in-network providers; (2) the Allowed Amount File — historical billed charges and allowed amounts paid to out-of-network providers; and (3) the Prescription Drug File — negotiated rates and historical net prices for covered Rx drugs. This third file is currently pending, with enforcement deferred pending federal guidance.

Federal regulations require MRFs to be updated at minimum monthly. Each file must reflect the date of its most recent update. Unified Health Plan maintains a monthly refresh cycle for all active MRFs, and the index file is refreshed to reflect any new or revised plan data.

MRFs must be in a nonproprietary, open format — specifically JSON (JavaScript Object Notation), per CMS technical implementation guidance. A PDF or proprietary format does not comply. Files must be freely accessible to any person without registration, login, or payment. Our files conform to the current CMS schema published on GitHub at github.com/CMSgov/price-transparency-guide.

For Employers & Plan Sponsors

Not necessarily. Per Department FAQs issued August 2022, a self-funded plan without a public website satisfies its MRF obligations entirely through a written agreement with a TPA that posts the files publicly. If your organization does have a public-facing website, you should post a link to this page or to the index file URL. Contact your Unified Health Plan account manager for the specific URL to reference.

Through a written agreement included in your TPA service contract, Unified Health Plan posts and maintains MRFs on behalf of your plan. This page serves as the public disclosure hub for all plans we administer. We generate the files, maintain the index, ensure monthly updates, and monitor regulatory changes. Your plan’s data is included in our index file, satisfying the federal posting requirement.

Under federal law, the plan sponsor (your organization) retains ultimate liability for MRF compliance even when a TPA is contractually responsible. If the TPA fails to post, the plan is in violation and may face enforcement action. We encourage all plan sponsors to periodically verify this page and the index file remain publicly accessible. You may seek indemnification from us through your service agreement, but that does not eliminate your plan’s regulatory exposure.

CMS technical guidance explicitly permits TPAs to aggregate MRF links for multiple plans into a single Table of Contents (index) file. This is the standard approach for TPAs administering many plans and is fully compliant. The index file contains an entry for every plan we administer, each with direct download URLs to that plan’s In-Network Rate and Allowed Amount files.

Contact your Unified Health Plan account manager and request confirmation that your plan is actively listed in the index file. We can provide you with your plan’s specific entry in the index and the direct URLs to your plan’s MRF files. New plans are added to the index file during onboarding.

Prescription Drug MRF

The Prescription Drug MRF was originally required alongside the other two files but enforcement was deferred shortly before the July 2022 deadline. In May 2025, the Departments of Labor, HHS, and Treasury rescinded the prior enforcement deferral, signaling the requirement will eventually activate. However, the effective compliance date remains TBD pending future guidance. No action is required from employers at this time.

Yes. We actively monitor regulatory developments from the Departments of Labor, HHS, and Treasury. When the Rx Drug MRF effective date is announced, we will proactively notify all client plan sponsors, publish the file, and add it to the index. This page will also be updated to reflect active status for that file type.

For Researchers & Developers

Download the index JSON file using the button at the top of this page. It contains an array of plan entries, each with the plan name, plan ID, and direct URLs to that plan’s In-Network Rate and Allowed Amount MRF files. Parse the index to locate the specific plan or plans you need, then fetch the individual MRF files from the URLs provided. Files conform to the CMS schema at github.com/CMSgov/price-transparency-guide.

In-Network Rate Files in particular can be extremely large — often hundreds of gigabytes for large plan networks. Files are served in compressed format where possible. We recommend using streaming JSON parsers rather than loading entire files into memory, and planning for adequate storage and compute resources before processing these files at scale.

Yes. CMS publishes the official technical implementation guidance and JSON schemas on GitHub at github.com/CMSgov/price-transparency-guide. The repository includes schema definitions, data element descriptions, valid value lists, and README documentation for each file type. All files published by Unified Health Plan conform to the current published schema version.

Health Plan Price TransparencyMachine-Readable Files