Transparency of Coverage

Public disclosure of prices in the HealthSelect of Texas^® and Consumer Directed HealthSelect^SM 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 HealthSelect^SM 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.