Marketplaces will offer only health insurance plans that are certified as qualified health plans, or QHPs. These QHPs must be licensed and accredited, and must meet certain requirements for transparency. To become certified, a QHP must meet a minimum set of criteria, including the following:
The Affordable Care Act requires that health plans offered in the individual and small group markets, both inside and outside of the Marketplaces, offer a comprehensive package of services, known as essential health benefits, or EHB. EHB include items and services within 10 benefit categories that are highlighted on the next page. The Affordable Care Act requires that EHB:
For plan years 2014 and 2015, each state was asked by HHS to select a specific health plan’s set of benefits as its “EHB-benchmark plan,” equivalent to a typical employer health plan. If the state did not choose a plan, the EHB-benchmark plan was determined by HHS. The EHB in each state will be measured against the state’s EHB-benchmark plan. Because states elected their EHB-benchmark plans from existing state plans that included state-specific benefits, the EHB package will vary from state to state. Starting in 2014, QHP issuers will need to ensure that every QHP offered in the Marketplace is substantially equal to the EHB-benchmark plan in the state where the QHP is offered.
Next Topic: Levels of Coverage
Agents and Brokers are required to be trained to assist consumers with the application and decision making process. Using an Agent to enroll in a ObamaCare Health Plan will be the primary choice of many americans. After all agents have the inside track on companies and their promptness to handle claims and pay benefits in atimely fashion.
Next Topic: Coverage Basics