HHS Proposal Would Offer Flexibility in Implementation of Essential Health Benefits

HHS has released a bulletin outlining proposed policies that would give states flexibility in defining their respective essential health benefits.

Under the healthcare reform law, health insurance plans are required to offer, both inside and outside of insurance exchanges, a comprehensive package of items and services, known as "essential health benefits."

Under HHS' proposal, states would have the flexibility to select an existing health plan to set the "benchmark" for the items and services included in the essential health benefits package. States would choose one of the following health insurance plans as a benchmark:

•    One of the three largest small group plans in the state
•    One of the three largest state employee health plans
•    One of the three largest federal employee health plan options
•    The largest HMO plan offered in the state's commercial market  

States and insurers would retain the flexibility to evolve the benefits package with the market as innovative plan designs are developed and advancements in care become available. Comments on this proposal are due by Jan. 31.

Related Articles on Insurance Exchanges:

HHS Issues Final Rule for CO-OP Program
CMS Selects CGI to Construct Federal Health Insurance Exchanges
HHS Gives $220M to 13 States for Health Insurance Exchanges

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