Essential Health Benefits Benchmark Hearing
Beginning January 1, 2014, the federal Affordable Care Act required health plans sold in the individual and small group markets to offer a comprehensive package of items and services known as "Essential Health Benefits." The federal government gave each state the authority to choose its "Benchmark" plan from one of ten options.
On Friday, June 22nd, 2012, an informational hearing was held a hearing to assist the Commissioner in developing a recommendation to the Legislature and Governor. This original hearing notice can be found at the bottom of this page. The hearing was held to discuss, gather information and provide interested and affected persons with an opportunity to present statements or comments to the Commissioner with respect to selection of an Essential Health Benefits benchmark plan by the State of California.
A video and transcript of the hearing can be found here: California Department of Insurance Commissioner's Hearing on California's Benchmark for Essential Health Benefits.
The following document was presented during the hearing on Friday morning, June 22nd, 2014: California's Benchmark for Essential Health Benefits (PDF version of the MS PowerPoint presentation)
Prior to the hearing, the following documents were made available for review:
Benefit Comparison document comparing the benefits for each of the ten plan options.
Evidence of Coverage documents used to analyze the ten plan options available for selection as the benchmark for Essential Health Benefits:
- Blue Shield/Blue Cross Basic and Standard (Federal Plan) - NOTE: There are TWO Evidence of Coverage documents in this link
- Government Employees Health Association, Inc. (Federal Plan)
- CalPERSChoice PPO
- Kaiser/CalPERS HMO
- Kaiser Large Group HMO
- Kaiser Small Group HMO
- Anthem Small Group PPO
- Anthem Small Group PPO30
- CalPERS Blue Shield Basic HMO
- Shield Spectrum PPO 1500
Original Hearing Notice:
NOTICE OF INFORMATIONAL HEARING REGARDING CALIFORNIA'S ESSENTIAL HEALTH BENEFITS BENCHMARK
NOTICE IS HEREBY GIVEN to Certain Interested and Affected Parties that Insurance Commissioner Dave Jones will hold a hearing as follows:
Date: Friday, June 22, 2012 Time: 9:00 a.m. - 12:00 p.m. Location: Employment Development Department (EDD) Auditorium, 722 Capitol Mall, Sacramento, CA 95814
The purpose of the hearing is to discuss and gather information and to provide interested and affected persons with an opportunity to present statements or comments to the Commissioner with respect to selection of an Essential Health Benefits benchmark plan by the State of California. This will assist the Commissioner in developing a recommendation to the Legislature and the Governor. Beginning January 1, 2014, the federal Affordable Care Act requires health plans sold in the individual and small group markets (both inside and outside the Exchange) to offer a comprehensive package of items and services known as "Essential Health Benefits." The federal government has given each state the authority to choose its "Benchmark" plan from one of ten options.
Information about the ten options can be found above and an overview of these options will take place at the hearing. The state may select from the following:
- The largest plan by enrollment in any of the three largest small group insurance products in the State's small group market.
- Any of the three largest state employee health benefit plans by enrollment.
- Any of the three largest national FEHBP plans options by enrollment.
- The largest insured commercial non-Medicaid HMO operating in the state.
The Commissioner invites all interested parties to present comments pertaining to the selection of an Essential Health Benefits benchmark plan. Members of the public and interested persons are encouraged to provide oral comments. All written materials and written comments, unless submitted during the hearing, should be received by the Insurance Commissioner, c/o Kim Morimoto, Senior Staff Counsel, Health Policy Approval Bureau, 45 Fremont Street, 21st Floor, San Francisco, CA 94105, no later than 5:00 p.m. on Friday, June 22, 2012.
The facilities to be used for the hearing are accessible to persons with mobility impairments. Persons with sight or hearing impairments are requested to notify the contact person for this hearing in order to make special arrangements, if necessary. In addition, any questions regarding this Notice should be directed to the contact person for this hearing:
Senior Staff Counsel Health Policy Approval Bureau
45 Fremont Street, 21st Floor
San Francisco, CA 94105
(415) 538-4143
Dated: June 12, 2012
DAVE JONES Insurance Commissioner
