Essential Health Benefits: HHS Informational Bulletin

Posted by ataylor@basusa.com - 16 December, 2011

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Today, the Department of Health and Human Services issued a bulletin on essential health benefits.
According to the release, when implementing essential health benefits in a state exchange, states would have the flexibility to select a benchmark plan that reflects the scope of services offered by a “typical employer plan.” This approach is intended to give states some flexibility.

States would choose one of the following benchmark health insurance plans:

  • One of the three largest small group plans in the state by enrollment;
  • One of the three largest state employee health plans by enrollment;
  • One of the three largest federal employee health plan options by enrollment;
  • The largest HMO plan offered in the state’s commercial market by enrollment.

If states choose not to select a benchmark, HHS intends to propose that the default benchmark will be the small group plan with the largest enrollment in the state.

The benefits and services included in the benchmark health insurance plan selected by the state would be the essential health benefits package. Plans could modify coverage within a benefit category so long as they do not reduce the value of coverage.

Click for HHS Bulletin...


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