Tip Tuesday! Understanding the Difference between Minimum Essential Coverage, Essential Health Benefits, Minimum Value, and Actuarial Value

By Lisa Klinger

There are several terms in the Affordable Care Act that sound similar and therefore cause some confusion. Each term has a different meaning and different ramifications—for employers and individuals—in terms of penalties, taxes and subsidies.    This article defines four such terms and explains how each applies to individuals and to employers.   The four terms are “Minimum Essential Coverage,” “Essential Health Benefits,”  “Minimum Value” and “Actuarial Value.”

Click here for entire article.

Feds want states to set minimum benefit limits in health exchanges

December 26, 2011 by Christian Schappel

The health reform law required the Dept. of Health and Human Services (HHS) to set minimum benefit limits for plans in health exchanges. But now the HHS wants to relinquish that responsibility to the states.

Insurance plans participating in state health exchanges will be required to offer a minimum amount of benefits, known as essential health benefits. Their plans must cover services in at least 10 categories, which include preventive care, emergency services, maternity care, prescription drugs, mental health and substance abuse.

But now, instead of the HHS determining what those limits will be, it looks like it’ll beleft up to the states to decide for themselves.

Click Here for more details on the proposal and the full article.