CHA News Article

Federal Government Releases Final Rule on Essential Health Benefits
Covered California announces benchmark benefits plan

The U.S. Department of Health and Human Services (HHS) has released the attached final rule outlining exchange and issuer standards related to coverage of essential health benefits (EHB) and actuarial value under the Affordable Care Act. The final rule defines EHB based on state-specific benchmark plans. States can select a benchmark plan from among several options, including the largest small-group private health insurance plan by enrollment in the state. The final rule requires all plans subject to EHB to offer benefits substantially equal to the benefits offered by the benchmark plan. 

Covered California was the first state exchange in the nation to announce its benchmark benefits plan for Californians in the individual and small employer group markets. Starting October 2013, consumers will be able to compare their costs for monthly coverage, out-of-pocket expenses, medication and annual maximum expenses. Coverage will begin Jan. 1, 2014. CHA is in the process of analyzing California’s plan in light of the recently released federal requirements. For more information on the state’s benchmark plan, see attached fact sheet and visit