On October 6, 2026, the Departments of Labor, Health and Human Services, and Treasury published final rules updating the machine-readable file (MRF) and price comparison tool requirements of the previously issued Transparency in Coverage (TiC) rules. Employers, as plan sponsors, have generally relied upon their health insurance carrier and third party administrator (TPAs) to comply with these requirements. However, employers should take note of the updated requirements and respond as necessary.
Online Price Comparison Tool Updates
The final rules require the online price comparison tool to provide cost sharing information over the phone, rather than exclusively in an online or paper format. This aligns TiC requirements with provisions of the 2021 Consolidated Appropriations Act that require a price comparison tool that is available both online and over the phone. A notice of federal balance billing protections must also be provided.
The updated requirements apply to plan years beginning on or after January 1, 2027.
Machine-Readable File Updates
The final rules contain numerous technical updates to the information that must be contained in the MRFs. These updates include, among other changes:
- Reporting in-network rate at the network level, rather than at the plan level;
- Removing providers who would never be reimbursed for a certain service;
- Requiring a utilization file showing what providers have actually been reimbursed;
- Requiring a footer on the website hosting the files;
- Making all files available in a standardized format.[1]
Attestation Requirement
Perhaps the most impactful change for employers is the requirement that the MRFs must contain an attestation that the data within the MRFs is accurate and provided in accordance with the regulatory requirements. The attestation must be made by a plan’s chief executive officer, president, or senior official designated to oversee the encoding of true, accurate, and complete data.
An employer sponsoring a fully insured health plan can enter into a written agreement with their health insurance carrier to post the required files with the required attestation.[2] The written agreement shifts liability for the files and attestation from the employer to the carrier.
An employer sponsoring a self-funded plan may enter into a written agreement with a third party, such as their TPA, to post the required files with the required attestation.[3] However, even if there is a written agreement, a self-funded employer remains liable for any issues with the files or attestation.
The attestation is required to be in the MRFs by March 6, 2027, so employers seeking to have a third party handle the attestation requirement on their behalf should ensure written agreements are updated by that point.
Key Takeaway: Employers, as plan sponsors, should be prepared to comply with the updated requirements for machine-readable files and the online price comparison tool. Written agreements should be reviewed and updated as necessary to ensure any agreement with a third party assisting an employer with TiC requirements addresses the new requirements.
[1] The required website footer must be posted by September 6, 2027. Changes to the in-network files (network level reporting and removing certain providers) and the single format requirement must be implemented by March 6, 2027. Finally, the utilization file must be posted by July 1, 2028.
[2] Attestation will come from chief executive officer, president, or senior official designated of carrier.
[3] Attestation will come from chief executive officer, president, or senior official designated of the third party.
The information provided is a summary of laws and regulations relating to employee benefit plan compliance. This information should not be construed as legal advice. In all cases, employers should consult with their own legal counsel.
