State Benchmark Plan Work Group

About

The Affordable Care Act requires non-grand-fathered health plans in the individual and small group markets to cover essential health benefits (EHB), which include items and services in the following ten benefit categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services including behavioral health treatment; (6) prescription drugs; (7) rehabilitative and habilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care.

For plan year 2020, and after, the Final 2019 HHS Notice of Benefits and Payment Parameters provides states with greater flexibility by establishing standards for States to update their EHB benchmark plans, if they so choose.

In the 2020 Final Letter to Issuers Participating on Maryland Health Connection, MHBE was tasked to create a work group to help determine whether the current benchmark plan meets the needs of the individual market. The work group will provide recommendations to the MHBE Board of Trustees on whether to leverage new state flexibility to modify the State Benchmark Plan.

Work Group Members

Meeting Dates

  • February 15: Welcome Webinar
  • February 22: 10AM-1PM
  • 100 Community Place
    Crownsville, MD 21032
    First Floor Conference Room, Side A

  • March 15: 10AM-1PM
  • 750 East Pratt Street, 6th Floor
    Baltimore, MD 21202
    Training Room

  • March 22: 10AM-1PM
  • 100 Community Place
    Crownsville, MD 21032
    First Floor Conference Room, Side A

  • March 29: 10AM-1PM
  • 100 Community Place
    Crownsville, MD 21032
    First Floor Conference Room, Side A

MeetingĀ Documents

Work Group Charter
Work Group Mission and Goals
Related Resources