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Essential Health Benefits

Georgia consumers purchasing health insurance deserve the peace of mind that comes from knowing that they are purchasing a quality plan that meets basic standards and that will provide adequate protection in the event they get sick. That is why Georgians for a Healthy Future is monitoring the essential health benefits selection process. As part of the Affordable Care Act (ACA), beginning in 2014 all health insurance plans sold in the private individual and small group markets must include a minimum package of benefits to ensure that all consumers purchasing health insurance have access to comprehensive health care services.

 

In a process outlined late last year by the U.S. Department of Health and Human Services, states were instructed to choose a benchmark plan and supplement it to fill any gaps (the essential health benefits package must, under federal law, include items and services within ten broad categories, described here). Georgia chose the default option, the largest small group plan sold within the state, as our state’s benchmark plan. According to the Georgia Department of Insurance, the U.S. Department of Health and Human Services (HHS) will review and supplement the plan. You can read more about this issue and Georgia’s decision to default to federal officials on the decision in Georgia Health News here.

 

Later this fall, HHS is expected to issue a notice of proposed rule-making listing each state’s minimum essential health benefits package. The National Academy for State Health Policy is also tracking all states’ progress on essential health benefits. You can view their latest chart here.

 

 


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