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Essential Health Benefits Hearing - June 22, 2012

Post Hearing

Video of the California's Benchmark for Essential Health Benefits hearing June 22, 2012 - Duration: 1 hr 54 min

hearing transcript is available.

During Hearing

The following document was presented during the hearing Friday morning, June 22, 2012.

California's Benchmark for Essential Health Benefits (PDF version of the MS PowerPoint presentation)

Prior to Hearing

Please review the information and documents linked below in preparation for the Essential Health Benefits Hearing scheduled for Friday, June 22, 2012. Hearing notice information can be found following the list of documents below.

Benefit Comparison document (PDF) comparing the benefits for each of the ten plan options. Please note: this document was updated as of 11:45 a.m., June 21, and will be the version used during the hearing discussion.

Evidence of Coverage documents used to analyze the ten plan options available for selection as the benchmark for Essential Health Benefits.


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. For more information, please see the federal Essential Health Benefits Bulletin.

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:

Kim Morimoto
Senior Staff Counsel
Health Policy Approval Bureau
45 Fremont Street, 21st Floor
San Francisco, CA 94105
(415) 538-4143

Dated:  June 12, 2012

Insurance Commissioner