AHIP offers advice on essential benefits and keeping premium costs affordable

Published on September 15, 2012 at 5:17 AM · No Comments

Meanwhile, Kansas officials are facing a ticking clock as they try to develop recommendations for what should make up the state's essential benefits in individual and small group health insurance policies.

CQ HealthBeat: AHIP Urges Leaner Benefits To Keep Premiums Affordable Under Health Law
A spokesman for the nation's biggest health insurance lobby testified in Congress this week that the health care law should be changed to require less generous benefits than it does now. "Consideration should be given to lowering the minimum actuarial value for coverage sold in the exchanges to ensure the availability of affordable coverage options and to allow smoother transitions to new benefits packages," said Daniel T. Durham, executive vice president with America's Health Insurance Plans. The law requires health coverage to meet a minimum set of "essential health benefits" that each state will determine based on one several benchmark plans. In addition, starting in 2014, policies sold through insurance exchanges must be at one of four benefit levels which vary based on the percentage of the actuarial value of the health care services the plans cover. The levels are bronze, 60 percent; silver, 70 percent; gold, 80 percent; and platinum, 90 percent (Reichard, 9/13).

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