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CA Department of Insurance

Insurance Commissioner Dave Jones Applauds Secretary Sebelius for Providing Flexibility to States Regarding Essential Health Benefits

News: 2011 Press Release

For Release: December 16, 2011
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Insurance Commissioner Dave Jones Applauds Secretary Sebelius for Providing Flexibility to States Regarding Essential Health Benefits

Insurance Commissioner Dave Jones today issued a statement after the U.S. Department of Health and Human Services (HHS) issued a bulletin including a number of policy proposals that provide states with a great degree of flexibility as they continue to implement the provisions of the Patient Protection and Affordable Care Act (PPACA). The bulletin serves as a blueprint of the approach HHS will take toward the rulemaking process in defining essential health benefits.

"I appreciate the flexibility that Health and Human Services Secretary Sebelius is providing to states with regard to determining the "essential health benefits" that health insurers and HMOs will be required to include in their benefit packages," Commissioner Dave Jones said. "I look forward to hearing from healthcare stakeholders regarding which option the state should choose in defining essential health benefits," continued Jones.

Under the HHS blueprint, states would be afforded the flexibility to choose a health insurance product to serve as a "benchmark" for the benefits and services that make up the "essential health benefits" package that health insurers and HMOs must offer to policyholders. According to the HHS bulletin, states would select one from among the following types of health insurance or HMO plans: (1) One of the three largest small group plans in the state; (2) One of the three largest state employee health plans; (3) One of the three largest federal employee health plan options; and (4) The largest HMO plan offered in the state's commercial market.

"Healthcare reform has already provided many benefits to California's consumers," Commissioner Jones said. "Today's HHS decision to provide states with flexibility in establishing California's essential health benefits package will assist us in bringing more of the long term benefits of the federal Affordable Care Act to individuals and families."

To view HHS' announcement, please visit:

The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $310 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at Non-media inquiries should be directed to the Consumer Hotline at 800.927.4357. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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