Machine Readable Files (MRFs)

Table of Contents Files

Files that allow multiple plans with the same rates to reference existing machine-readable files.

File Name

File Type

Date Created

Action

1199SEIU Table of Contents Table of Contents June 1, 2024

In-network Rates & Allowed Amounts Files

Files that contain specific information about covered items and services for in- and out-of-network provider rates.

Plan Name

File Type

Date Created

Action

1199SEIU Greater New York Benefit Fund for New Jersey
  • In-network Rates
  • Out-of-network Allowed Amounts
June 1, 2024
1199SEIU National Benefit Fund for Rochester
  • In-network Rates
  • Out-of-network Allowed Amounts
June 1, 2024
Aetna Choice POS II
  • In-network Rates
June 1, 2024

Machine-readable files are a requirement of the Federal Government’s Transparency in Coverage Final Rule. Beginning in 2022, all health insurers are required to publicly display certain healthcare price information through machine-readable files on their websites. These machine-readable files include negotiated rates with in-network providers and allowed amounts for out-of-network providers.

Disclaimer

  • These files are not designed for use as a consumer tool. These files are not a guarantee of coverage, nor a guarantee of the reimbursement rate that will be applied for any procedure. The claims reimbursement process is subject to a variety of factors that are not addressed in these files, including eligibility, medical necessity determinations, utilization management requirements, exclusions and other plan terms. These files also do not offer any information on a member's out-of-pocket charges, if applicable. The information in these files is accurate as of the date noted for each file and is subject to change without notice.
  • The 1199SEIU Benefit Funds work with partners, including leased networks, for some services. The Benefit Funds do not have access to the contract terms our partners have with their providers. We depend on information provided by our partners to be complete and accurate based on our partners' good faith efforts.