Health News
The Kentucky Department of Insurance has recommended that the Anthem Preferred Provider Organization (PPO) plan serve as the ?benchmark? plan for the Kentucky Health Benefit Exchange, as well as for plans offered outside the exchange. The statement issued by the department states that "Anthem PPO is the largest small group plan currently offered in Kentucky and includes coverage for all state mandates and the 10 essential health benefits, or categories of care, specified by the federal government under the Patient Protection and Affordable Care Act. The benchmark plan sets the minimum level of benefits offered in the individual and small group markets beginning Jan. 1, 2014."
According to the release, the Anthem PPO plan "is the most cost-effective of the 10 plans reviewed, will not create additional costs for the state and should not increase the price for those who have coverage today. Since the Anthem PPO plan does not offer the minimum requirements for pediatric vision and dental services, Kentucky has recommended that the benefits in the Kentucky Children?s Health Insurance Program (KCHIP) be substituted in the benchmark plan."
Some background, also provided by the Dept. of Insurance: One of the goals of the Affordable Care Act is to ensure that Americans will have access to quality, affordable health insurance. To achieve this goal, the law ensures health plans offered in the individual and small group markets offer a comprehensive package of items and services, known as Essential Health Benefits. The act provides that the EHBs include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. For more on Essential Health Benefits, go here.
The U.S. Department of Health and Human Services will review the Athem recommendation and accept public comments prior to making a final decision on the matter.
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Health News
Anthem PPO plan chosen as 'benchmark' for state's Kentucky Health Benefit Exchange
The Kentucky Department of Insurance has recommended that the Anthem Preferred Provider Organization (PPO) plan serve as the ?benchmark? plan for the Kentucky Health Benefit Exchange, as well as for plans offered outside the exchange. The statement issued by the department states that "Anthem PPO is the largest small group plan currently offered in Kentucky and includes coverage for all state mandates and the 10 essential health benefits, or categories of care, specified by the federal government under the Patient Protection and Affordable Care Act. The benchmark plan sets the minimum level of benefits offered in the individual and small group markets beginning Jan. 1, 2014."
According to the release, the Anthem PPO plan "is the most cost-effective of the 10 plans reviewed, will not create additional costs for the state and should not increase the price for those who have coverage today. Since the Anthem PPO plan does not offer the minimum requirements for pediatric vision and dental services, Kentucky has recommended that the benefits in the Kentucky Children?s Health Insurance Program (KCHIP) be substituted in the benchmark plan."
Some background, also provided by the Dept. of Insurance: One of the goals of the Affordable Care Act is to ensure that Americans will have access to quality, affordable health insurance. To achieve this goal, the law ensures health plans offered in the individual and small group markets offer a comprehensive package of items and services, known as Essential Health Benefits. The act provides that the EHBs include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. For more on Essential Health Benefits, go here.
The U.S. Department of Health and Human Services will review the Athem recommendation and accept public comments prior to making a final decision on the matter.
- How To Succeed In Health Insurance For Your Small Business Without Really Trying -- Well, Maybe Without Trying Too Hard
UPDATE, Feb. 11: The Obama administration has again delayed and relaxed the requirements for employers to provide health insurance. Employers with 50 to 99 employees won't be required to cover them until 2016, and those with 100 or more will only...
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- Illinois Essential Health Benefits Benchmark Plan
The State of Illinois has selected its Essential Health Benefits benchmark plan - the Blue Cross Blue Shield of Illinois BlueAdvantage Entrepreneur plan. This plan sets the bar for 10 categories of health care benefits (called "Essential Health Benefits"...
- Illinois Begins Essential Health Benefits Discussion
Governor Pat Quinn recently announced that the benchmark plan for Illinois? Essential Health Benefits (EHB) package will be chosen by September 30, in order to meet the Federal deadline for selecting a plan. A public meeting on Wednesday, September 12th,...
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In December 2011, the Department of Health and Human Services released long-awaited regulations on the Essential Health Benefits (EHB). A major piece of the Affordable Care Act, EHB will define the minimum level of coverage that must be offered in plans...