Beneflex Compliance Alerts

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things.  Here's a closer look at these terms, and when they're used.

Essential Health Benefits
Significantly affects individuals and small employers with a fully insured plan.  Has a limited impact on self-funded and large insured plans.

Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 "essential health benefits" regardless whether the policy is purchased through or outside the exchange.  Self-funded plans (regardless of size), large group plans, and grandfathered plans (regardless of size) do not have to cover all 10 essential health benefits, but they will not be allowed to put lifetime or annual dollar limits on an essential health benefit.

Each state will have its own "benchmark" essential health benefits package. The essential health benefit categories are ambulatory/outpatient, emergency, hospitalization, maternity and newborn care, mental health and substance use, prescription drugs, rehabilitative and habilitative services and devices (for example, speech, physical and occupational therapy), laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including pediatric dental and vision care. 

Minimum Essential Coverage
Affects most individuals and all employers with 50 or more employees (regardless whether its plan is self-funded or fully insured).

Beginning in 2014, most Americans will be required to have "minimum essential coverage" or pay a penalty with their tax return. (In 2014, the penalty will be the greater of 1 percent of income or $95.