HHS Releases Guidance on Essential Health Benefits - December 20, 2011

The U.S. Department of Health & Human Services (HHS) released guidance on essential health benefits plans on Dec. 16. HHS’ approach would allow states to select from existing health plans items and services to be included in an essential health benefits package. The package must cover items and services in at least 10 categories of care. Coverage in a particular category could be modified as long as the value of coverage is not reduced.

States would choose from four benchmark health insurance plans: 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 plans or the largest HMO plan offered in the state. According to HHS’ announcement, the new policy would “give states the flexibility to select a plan that would be equal in scope to the services covered by a typical employer plan.”