2011 Federal Exchange Guidance
Joint California Comments on Essential Health Benefits Bulletin Submitted to Health and Human Services Secretary Sebelius:
The Exchange submitted comments jointly with the Department of Health Care Services, Department of Managed Health Care, Department of Insurance, and the Managed Risk Medical Insurance Board on the federal Essential Health Benefits Bulletin. The letter was informed by the Exchange board meetings and comments received.
Joint California Comment Letter on Essential Health Benefits Bulletin
Federal Government Releases Proposal for Essential Health Benefits:
On December 16, 2011, the federal government released an essential health benefits bulletin that included a proposal to permit states to select an existing plan to set the benchmark for items and services included in the essential health benefits package. Members of the public may submit comments about the proposal to the federal government until January 31, 2012. The bulletin may be accessed at:
http://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdf
Updated Analysis on Essential Health Benefits
On December 16, 2011, the U.S. Department of Health and Human Services (HHS) released a Bulletin describing the approach it intends to take in future rulemaking to define the essential health benefits (EHB) under the Affordable Care Act. This document is intended to provide additional guidance on HHS's intended approach to defining EHB.
- CMS FAQs on Essential Health Benefits
- Milliman - Essential Health Benefits - Comparison of Costs and Services
- Milliman - Essential Health Benefits - Plan Benefit Comparison
- Evidence of Coverage Used by Milliman for Analysis
Comments on Notice of Proposed Rulemakings:
- California Health Benefit Exchange Cover Letter and Comments on Proposed Rules for Summary of Benefits and Coverage and the Uniform Glossary (Submitted October 21, 2011)
- Cover Letter – Comments on Establishment of Exchanges and Qualified Health Plans and Reinsurance, Risk Corridors, and Risk Adjustment NPRMs (Submitted October 31, 2011)
- California Joint Comments on Proposed Rules for the Establishment of Exchanges and Qualified Health Plans (Submitted October 31, 2011)
- California Joint Comments on Proposed Rules for Reinsurance, Risk Corridors, and Risk Adjustment (Submitted October 31, 2011)
- Cover Letter – Comments on Health Insurance Premium Tax Credit; Exchange Functions in the Individual Market, Eligibility Determinations, and Exchange Standards for Employers; and Eligibility Changes to Medicaid NPRMs (Submitted October 31, 2011)
- California Joint Comments on Proposed Rules for Premium Tax Credits (Submitted October 31, 2011)
- California Joint Comments on Proposed Rules for Exchange Functions in the Individual Market; Eligibility Determinations; and Exchange Standards for Employers (Submitted October 31, 2011)
- California Joint Comments on Proposed Rules for Medicaid Programs: Eligibility Changes under the Affordable Care Act of 2010
Notice of Proposed Rulemakings:
- August 22, 2011:Summary of Benefits and Coverage and the Uniform Glossary
- August 17, 2011:ACA Exchange Functions in the Individual Market; Eligibility Determinations; Exchange Standards for Employers
- August 17, 2011:Health Insurance Premium Tax Credit
- August 17, 2011:Medicaid Program; Eligibility Changes Under the ACA
- July 15, 2011:ACA Establishment of Exchanges and Qualified Health Plans
- July 15, 2011:ACA Standards Relating to Reinsurance, Risk Corridors, and Risk Adjustment
- July 20, 2011:ACA Establishment of Consumer Operated and Oriented Plan Program (CO-OP)