Essential Health Benefits Information

Requirements of the Affordable Care Act

Beginning in 2014, most health insurance plans sold to small employers and individuals must include a minimum set of health care services and products. This set of services and benefits is called the “Essential Health Benefits.”  By October 1, 2012, each state must choose a health plan from its current marketplace that will serve as the Essential Health Benefits Benchmark plan. The federal government issued a bulletin and FAQ  in December 2011 which provides a framework for the selection process.

Final Colorado Essential Health Benefits Benchmark Plan Selection
September 27, 2012
Colorado's Essential Health Benefits Final Benchmark Plan Selection Chart
September 27, 2012
Frequently Asked Questions Regarding Essential Health Benefits Draft Recommendation
September 27, 2012

Colorado's EHB Benchmark Plan Options comparison chart, updated 9/6/12

Draft Recommendations for EHB Benchmark Plan

Colorado's EHB Selection Process The Governor’s Office, the Division of Insurance and the Colorado Health Benefit Exchange held a public webinar on Friday, June 29 to discuss the process of selecting an Essential Health Benefits (EHB) benchmark plan for Colorado.  Colorado will choose an EHB benchmark plan in the coming months, which will establish minimum health benefits required for many Colorado  health insurance plans beginning in 2014.  In addition to answering common questions about the process, the webinar provided an introductory overview of a chart that details Colorado’s options for an EHB benchmark plan. Key information presented includes:

Colorado's Essential Health Benefit Benchmark Plan - Introductory Webinar (Windows Media Player required) June 29, 2012

Webinar Powerpoint slides

Comparison Chart-Colorado EHB Benchmark Plan Options   This chart shows the nine plans Colorado is considering for its EHB benchmark plan.

Comparison Chart - Colorado HEB Benchmark Plan Options - Excel version This chart cannot be modified. 

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Summary Description Forms The information below provides the Health Plan Summary Description Form for six of the nine potential benchmark plan options as outlined in the comparison chart. Summary Description Forms are not available for the two federal health plans.
Option A-Kaiser Permanente (Small Group) Summary Description Form	Option B - United Healthcare (Small Group) Summary Description Form
Option C - Anthem (Small Group) Summary Description Form	Option D - Kaiser Permanente HMO (Large Group) Summary Description Form
Option E - Kaiser Permanente (Colorado state employee plan) Summary Description Form	Option F - United Healthcare (Colorado state employee plan) Summary Description Form

Complete Policy Forms The information below provides the detailed Policy Forms for each potential benchmark plan option as outlined in the comparison chart.
Option A-Kaiser Permanente (Small Group) Complete Policy Form	Option B - United Healthcare (Small Group) Complete Policy Form
Option C - Anthem (Small Group) Complete Policy Form	Option D - Kaiser Permanente HMO (Large Group) Complete Policy Form
Option E - Kaiser Permanente (Colorado state employee plan) Complete Policy Form	Option F - United Healthcare (Colorado state employee plan) Complete Policy Form
Options G & H - Blue Cross Blue Shield (Federal employee health plan) Complete Policy Form	Option I - Government Employees Health Association Benefit Plan (federal) Complete Policy Form

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Public comments were accepted through August 5. Stakeholders were encouraged to comment on their preferences for a plan, and asked to address the following benchmark objectives:

• Include state-mandated benefits
• Provide coverage in required categories
• Be minimally disruptive to the market
• Promote carrier and consumer participation
• Balance comprehensiveness and affordability

The EHB working group also responded to questions submitted by stakeholders
Colorado's Essential Health Benefits Benchmark Plan - Response to Stakeholder Questions
EHB Response to Stakeholder Questions, July 27, 2012

Public comments intended to inform the decision-making process surrounding EHBs (eg, “formal” comments or position papers) are posted below.

Review comments received as of 8/6/12

Review comments on draft recommendation received as of 9/14/12

Public stakeholder input meetings

The Essential Health Benefits work group held two stakeholder meetings in July. Documents presented at those meetings are listed below.

Tuesday, July 31, 2012
Related documents
EHB Stakeholder Meeting Agenda July 31, 2012
July 31 Public Meeting Powerpoint
Factors Affecting Health Insurance Premiums 2014

Wednesday July 18, 2012
Related documents
EHB Stakeholder Meeting Agenda July 18, 2012
Pediatric Dental Benefits
Overview of Options Related to Habilitative Coverage
July 18 Public Meeting Powerpoint

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