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Life Health > Health Insurance > Your Practice

PPACA: Panel OKs Md. essential health benefits benchmark

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ANNAPOLIS, Md. (AP) — A Maryland panel working on implementing the Patient Protection and Affordable Care Act (PPACA) voted Thursday to use the state employee health plan as a benchmark for other plans that will be available to small businesses and individuals for two years, starting in 2014.

The Maryland Health Care Reform Coordinating Council selected the state employee plan after reviewing 10 eligible ones. The panel also voted to include pediatric vision and pediatric dental coverage.

While health care plans won’t have to mirror the state employee health plan in Maryland, they will have to essentially make equivalent offerings. Maryland Department of Health and Mental Hygiene Secretary Joshua Sharfstein compared the process to deciding the nutritional value of a meal.

“It’s not exactly picking what the meal is,” Sharfstein said. “It’s saying that we want there to be four food groups.”

The state employee benchmark plan will be in effect starting from January 2014 through January 2016.

“This sort of helps the insurance companies design their plans,” Sharfstein said.

The panel set the benchmark because the federal government has adopted a two-year transitional policy for states to select a plan from a menu of 10 options already sold in their states to act as a benchmark.

The council is co-chaired by Sharfstein and Lt. Gov. Anthony Brown.

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