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ARTICLE · 27 FEBRUARY 2013

HHS Issues Final Rule On Essential Health Benefits, Plan Value

Littler Mendelson
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The U.S. Department of Health and Human Services has issued a final rule setting forth the future health insurance exchange and insurance issuer standards related to coverage of essential health benefits and actuarial value.

United StatesEmployment and HR
Littler Mendelson, P.C.
Littler Mendelson, P.C.
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The U.S. Department of Health and Human Services (HHS) has issued a final rule setting forth the future health insurance exchange ("Exchange") and insurance issuer standards related to coverage of essential health benefits (EHB) and actuarial value. In addition, the final rule establishes a timeline for when qualified health plans (QHPs) should be accredited in federally facilitated Exchanges.

Starting January 1, 2014, non-grandfathered insurance plans in the individual and small group market and those in the Exchanges will be required to provide coverage of benefits or services in 10 separate categories that reflect the scope of benefits covered by a typical employer plan. A QHP is one that provides a benefits package that covers EHB, includes cost-sharing limits, and meets minimum value requirements.

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