Essential Health Benefits

Public Comment Period

Public comment is invited concerning Rhode Island's benchmark options, the proposed criteria for evaluating those options and the choices that have been identified for supplementing pediatric vision, pediatric dental and habilitative services. Any comments will be considered public and will be shared with the workgroup during its final meeting on August 27, 2012.

Please submit your comments via e-mail to: ehbcomment@ltgov.state.ri.us by close of business on August 20, 2012.

Questions?

Please Contact Lindsay McAllister with any questions at 401.222.2371 or lmcallister@ltgov.state.ri.us.

Background

Starting in 2014, the Affordable Care Act (ACA) requires that all health plans offered in the individual and small group markets cover a comprehensive set of services, known as essential health benefits (EHB). This list of 10 statutory categories can be found in § 1302 of the ACA, and additional guidance on this provision of the bill can be found in a bulletin released by the U.S. Department of Health and Human Services (HHS) in December 2011 and a set of FAQ's released earlier this year (also available at the website below). The 10 essential health benefit categories will be defined using a benchmark plan to be selected by the state from among a list of existing health plans provided by HHS. This decision must be transmitted by the Governor to HHS by the end of September 2012.

To inform this determination, an EHB workgroup was formed under the auspices of the Rhode Island Health Reform Commission. This workgroup has met several times over the past few months to identify decision points for the state, develop and apply criteria for analyzing the state's benchmark options, and better understand the process for, and implications of, supplementing EHB categories into the benchmark plan. Agendas, presentations and minutes taken for each of these meetings is available here: http://www.healthcare.ri.gov/commission/workgroups/ehb.php.