State Benchmark Plan Work Group


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.

FINAL 2019 State Benchmark Plan Report

State Benchmark Plan Work Group Comments

Work Group Members

Work Group Charter

Meeting Dates

    • February 15: Welcome Webinar


    • February 22: 10AM-1PM

Agenda 2.22.19
Meeting Minutes
CMS Final Example
Benchmark Plan Summary
Feb. 22 Presentation
Essential Health Benefits Background

    • March 15: 10AM-1PM

Agenda 3.15.19
March 15 Presentation
Meeting Minutes

    • March 22: 10AM-1PM

Agenda 3.22.19
March 22 Presentation
Meeting Minutes

100 Community Place
Crownsville, MD 21032
First Floor Conference Room, Side A

    • April 5: 10AM-1PM

April 5 Presentation

100 Community Place
Crownsville, MD 21032
First Floor Conference Room, Side A

    • April 12: 10AM-1PM

Agenda 4.12.19
Meeting Minutes 4.12.19
April 12 Presentation

    • April 26: 10AM-1PM

Agenda 4.26.19
Meeting Minutes 4.26.19
April 26 Presentation

MHBE Office’s
750 East Pratt Street, 6 th Floor
Baltimore MD 21202
Training Room