OFIR Seeks Public Comment on Michigan Essential Health Benefits

State will select health benefit standards for certain plans sold in Michigan

May 24, 2012
Media Contact: Jason Moon 517-335-1700
Consumer Hotline: 877-999-6442
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LANSING - The Office of Financial and Insurance Regulation is seeking public comments on the selection of the state’s essential health benefits. Beginning in 2014, the Federal Affordable Care Act requires health plans sold in the individual and small group markets to offer a comprehensive package of items and services, known as “essential health benefits.” 

The State of Michigan must select its benchmark plan by September 2012.

“We welcome public input and encourage anyone with comments to submit them electronically,” Commissioner Kevin Clinton said.

The state must select a benchmark plan from one of the following:

• One of the three largest small group plans in the state by enrollment;
• One of the three largest state employee health plans by enrollment; 
• One of the three largest federal employee health plan options by enrollment;
• The largest HMO plan offered in the state’s commercial market by enrollment.  

Essential health benefits must include items and services within the following 10 categories:

1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care

Interested parties can view a comparison of essential health benefits benchmark plans and more information by visiting: http://www.michigan.gov/difs/0,5269,7-303-12902_61590-278783--,00.html.    

Public comments will be accepted through June 29, 2012 and should be sent to OFIR-EHBcomments@michigan.gov.