The Transparency in Coverage Rule (TCR) requires self-funded health plans and insurers to disclose rates and other price information for all covered billable services to improve health plan transparency in the cost of health services. Wellmark has provided two machine-readable files publicly available beginning July 1, 2022, including:

• • In-network allowed amount
  • Out-of-network allowed amount, if applicable, based on threshold requirement.

Review the public files effective July 1, 2022. 

Downloading files

The files are a specific file type, JavaScript Object Notation (.json.gz file format), as the law prescribes. Wellmark cannot make the files available in other formats.

Please note as machine-readable files, they are not readily interpretable by consumers. As such, members are encouraged to use the more member-friendly Find Costs tool available through myWellmark.com. The tool can help you find providers and determine how much a visit will cost you before receiving services. The machine-readable files do not provide information on a member’s out-of-pocket charges.