The Federal Government's Transparency in Coverage (TiC) Final Rule on November 12, 2020, and the subsequent Consolidated Appropriations Act (CAA) 2021, require group health plans to publish publicly available machine-readable files (MRFs) that contain the negotiated rates for in-network providers and allowed amounts derived from historical claims for out-of-network providers. Based upon the data provided to us by our network partners, Pan-American Life is making the following MRFs available on behalf of the plan-sponsors of self-funded plans that we administer. The clients/plan-sponsors for which the disclosure is being made is listed in a separate file that is also available on this site.
Consumers of these files should be aware that the group benefits provided under these plans vary from plans that cover only preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) recommendation A & B, the Advisory Committee on Immunization Practices (ACIP), the Health Resources and Services Administration's (HRSA's) Bright Futures Project, and HRSA and the Institute of Medicine (IOM) committee on women's clinical preventive services, through enhanced plans that cover additional services as provided for in our plan-sponsor agreements. Furthermore, the self-funded plans administered by Pan-American Life do not provide any Out-Of-Network benefits and as such do not provide for a file of Out-Of-Network charges and allowed amounts.