Essential Health Benefits Proposal Presents Challenges for Plan Sponsors

The Center for Consumer Information and Insurance Oversight (CCIIO) of the Department of Health and Human Services (HHS) has issued an Essential Health Benefits Bulletin (the CCIIO bulletin)1 that provides a preview of how HHS intends to define “essential health benefits” under the Affordable Care Act.2 Subsequent answers to frequently asked questions (FAQs) about the CCIIO bulletin clarify the impact of the proposal on group health plans.3 Together the documents can be used by plan sponsors to determine when specific benefits may or may not be permitted to contain annual or lifetime dollar limits. This Capital Checkup addresses the implications of the CCIIO bulletin for plan sponsors.

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