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2022 Session

Budget Amendments - HB30 (Floor Approved)

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Review of Essential Health Benefits (language only)

Item 493 #1h

Item 493 #1h

Independent Agencies
State Corporation Commission

Language

Page 516, after line 20, insert:

"C. 1. The State Corporation Commission (Bureau of Insurance) shall study and analyze the Commonwealth's options for potential implementation in 2025 of a new Essential Health Benefit (EHB) benchmark plan for individual and small group health insurance coverage that comply with federal regulations 45 CFR 156.111 (State selection of EHB-benchmark plan for plan years beginning on or after January 1, 2020, and annual reporting of state-required benefits). The Bureau of Insurance shall report its findings to the Health Insurance Reform Commission, and the Chairs of the House Committee on Appropriations and Senate Committee on Finance and Appropriations by November 1, 2022.

2. Until the Commonwealth makes a determination to select a new Essential Health Benefit benchmark plan, no qualified health plan shall be required to provide any state-mandated health benefit that is not provided in the essential health benefits package."



Explanation

(This amendment provides direction to the State Corporation Commission's Bureau of Insurance to analyze Essential Health Benefits (EHB) benchmark plan models for consideration when the Commonwealth begins operating its State Health Benefit Exchange. The SCC's Bureau of Insurance is required to report its findings to the Health Insurance Reform Commission, and the Chairs of the House Committee on Appropriations and Senate Committee on Finance and Appropriations by November 1, 2022 for their consideration. Language is also added to clarify that qualified health plans are not required to provide state-mandated health benefits that are not part of the current essential health benefits package until a determination is made about the composition of those benefits.)