This document is about the instructions and details on the open negotiation process and Federal independent dispute resolution (IDR) process that group health plans, health insurance issuers, and providers can use to determine the out-of-network rate for certain healthcare services. It explains the purpose of the open negotiation period, what happens at the end of the period if an agreement is not reached, and how to initiate the Federal IDR process. The document also includes a template for the open negotiation notice that must be used to start the open negotiation period.