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Update on Essential Health Benefits

Georgians for a Healthy Future is monitoring developments at the federal level that will impact benefits and consumer protections for new individual and small group health plans in Georgia beginning in 2014. In December, the Center for Consumer Information and Insurance Oversight (CCIIO), the division of the U.S. Department of Health and Human Services charged with implementing the provisions of the Affordable Care Act (ACA) related to private health insurance, released a bulletin on the essential health benefits (EHB) that all new plans will need to include.

The bulletin allows states to select the EHB for plans in their state from ten benchmark plan options. These include: (1) any of the three largest Federal Employees Health Benefits Program (FEHBP) plans by enrollment, (2) any of the three largest state employee health benefit plans by enrollment, (3) the largest plan by enrollment in any of the three largest small group insurance products offered in the state, or (4) the largest commercial non-Medicaid Health Maintenance Organization (HMO) plan in the state.

Information about which plans these are in Georgia can be found here. Georgia has not yet made a benchmark selection from among these plans, and we are working to identify more specifics about the benefit packages within these plans. We will keep advocates informed as we learn more about this ongoing process. If you’re also monitoring developments around EHB, please share information with us so we can communicate it to a range of health care advocates.


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