If finalized, states would have the flexibility to select an existing health plan to set the benchmark for the ten components included in the initial essential health benefits package of healthcare reform. States would choose one of the following health insurance plans as a benchmark, with “largest” meaning “most enrolled”:
- One of the three largest small group plans in the state;
- One of the three largest state employee health plans;
- One of the three largest federal employee health plan options;
- The largest HMO plan offered in the state’s commercial market.
The idea driving this is that insurance needs and the markets they’re priced in vary by state today. HHS is attempting to provide some flexibility per local needs that is also representative of that market within the federal standard required.
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Check out the actual HHS press release, including the link for public comments, here.