"Essential health benefits" and Ohio's role
The Health Policy Institute of Ohio has prepared "An Introduction to "essential health benefits' - Ohio's role in determining services covered by insurance post-2014."
The Patient Protection and Affordable Care Act (ACA) requires that most small group and individual health insurance plans offer a comprehensive package of covered items and services known as “essential health benefits” (EHB) beginning January 1, 2014.
Ohio policymakers have an opportunity to identify Ohio’s benchmark for Essential Health Benefits from the specified alternatives, with a third quarter 2012 deadline. If Ohio policymakers do not identify the benchmark, the default benchmark will be the largest small group plan, the Anthem PPO. In considering what this means for Ohioans purchasing coverage in the small group and individual markets, Ohio’s policymakers and other stakeholders must balance the desire for consistency and comprehensiveness of benefits with potential increased cost in covering these benefits. Additional analysis may be necessary when the final rules and other related guidance to Essential Health Benefits are released by the federal government.
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The Health Policy Institute of Ohio is a 501(c)3 nonprofit organization that serves as Ohio’s nonpartisan, independent source for forecasting health trends, analyzing key health issues, and communicating current research to policymakers, state agencies and other decision-makers.