About Developing Colorado’s Essential Health Benefits Package

January 18, 2012 at 10:30 AM
COPIC, Mile High Room, 7351 E. Lowry Blvd., Denver, 80230
Call-In:  1-888-330-9939 PIN# 632148#
Please see COHBE’s announcement for more details.

On December 16th, the Department of Health and Human Services released the Essential Health Benefits Package Bulletin.  COHBE and DOI are hosting this meeting to focus on the development of the EHBP for Colorado.

The Affordable Care Act requires that all individual and small group plans (both inside and outside of the state exchanges) cover “essential health benefits.”  While the ACA included a list of 10 categories of health services insurers must provide, the health care community has been waiting for a more specific regulation on the EHBP requirements.  The Bulletin, to the surprise of many did not create a list of services required nationwide, but instead allows states to pick a benchmark plan that represents their “typical employer plan.”  Click here for the HHS fact sheet on EHBs.

States will choose one of the following benchmark health insurance plans: 1) One of the three largest small group plans in the state by enrollment; 2) One of the three largest state employee health plans by enrollment; 3) One of the three largest federal employee health plan options by enrollment; 4) The largest HMO plan offered in the state’s commercial market by enrollment.  



For those planning to participate please note these comments from the announcement of the meeting:

“This meeting will focus exclusively on the questions we have related to creating a Colorado EHBP, and will not discuss the content of the EHBP, including individual benefits, benefit levels, and cost-sharing structures, as these decisions are still far out on the horizon.

At the meeting, we will share an overview of the bulletin, discuss our process to-date, and receive verbal stakeholder input.  However, because both time and space are extremely limited, individuals and organizations wishing to share input with the DOI and COHBE regarding the bulletin are encouraged to do so in writing any time before close of business on January 19, 2012.  Stakeholder input may be sent to jo.donlin@dora.state.co.us.  As discussed above, please limit your input to questions related to developing Colorado’s EHBP and exclude considerations regarding EHBP content.  Also, the space can only hold 130 individuals. We respectfully request each organization send only one representative to the meeting.”

Formal comments to HHS may be submitted to EssentialHealthBenefits@cms.hhs.gov

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