The Affordable Care Act (or ACA) will require non-grandfathered health insurance plans in the individual and small group markets to cover a comprehensive set of items and services, known as the essential health benefits (EHB) package. This coverage requirement will become effective in 2014.

ACA broadly identified 10 benefit categories to be included as EHB. ACA also directed the Department of Health and Human Services (HHS) to provide more specific guidance on the items and services that make up the EHB package.

On Dec. 16, 2011, HHS released an informational bulletin (Bulletin) that described the approach it intends to take in future rulemaking to outline EHB. This approach defers to the individual states by giving them flexibility to select their own benchmarks for defining EHB. In connection with the Bulletin, HHS also released FAQs to provide more guidance on HHS's intended approach for specifying EHB.

This MacCorkle Insurance Service Legislative Brief contains HHS's FAQs regarding defining EHB that are relevant to group health plans.

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