Transparency of Coverage

Public disclosure of prices in the HealthSelect of Texas® and Consumer Directed HealthSelectSM plans

The Transparency in Coverage final rule issued on October 29, 2020, requires most group health plans and health insurance issuers to provide public disclosures in machine-readable files regarding in-network, out-of-network and prescription drug prices. This health plan price transparency helps consumers know the cost of a covered item or service before receiving care. The information on this webpage was designed to comply with the Transparency in Coverage Final Rule requirements.

ERS and the third-party administrator of the HealthSelect of Texas® and Consumer Directed HealthSelectSM plans, Blue Cross and Blue Shield of Texas (BCBSTX), share pricing information with the public through these machine-readable files, which contain in-network and out of network files. 

The in-network file discloses negotiated rates between plans and providers for covered items and services. The out-of-network (allowed amount) file discloses unique allowed amounts and billed charges for out-of-network services. Both files are significantly larger than average website downloads and are provided in JSON format.