Transparency in Coverage
Transparency in Coverage
Transparency in Coverage is a federal rule by the Internal Revenue Service, the Employee Benefits Security Administration, and the Health and Human Services Department created on 11/12/2020 and further supported and clarified by Colorado Senate Bill 24-080, Transparency in Health-Care Coverage. The act requires health insurance carriers (carriers) to comply with federal price transparency laws and to make available an internet-based self-service tool that provides real-time responses to a covered person's questions concerning carrier prices that are based on cost-sharing information. The act also requires carriers to submit information required by federal pharmacy benefit and drug cost reporting laws to the commissioner of insurance and to make certain information regarding price transparency publicly available.
TiC Email List
To receive TiC updates directly in your inbox, please request to be added to the email list by emailing dora_ins_data@state.co.us. Please include your name, position and contact information in the email.
Carrier Guidance
Please find the most up-to-date technical carrier guidance below:
Contact Information
If you have questions or require further clarification on TiC, please contact dora_ins_data@state.co.us
Enforcement Authority:
In November 2025, CMS acknowledged Colorado's authority to enforce the federal Transparency in Coverage requirements. Click here to access the letter.
2026 January Submission:
To ensure continued compliance with all federal guidelines, carriers are requested to adhere to the following schedule for Machine-Readable File (MRF) submissions:
- January 2, 2026: Submission utilizing the federal 1.0 schema.
- July 1, 2026: Submission utilizing the federal 2.0 schema.
For PBMs:
Pharmacy Benefit Managers (PBMs) are required to submit RxDC files annually. If you are a PBM or an authorized representative who successfully submitted the required files in August 2025, you are not required to submit them again, or complete an exemption form, during the upcoming January reporting period.
Click here to access Colorado-specific Transparency in Coverage data download links.