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Michael Petruzzelli

, National Council for Mental Wellbeing

CMS Finalizes Essential Health Benefits Benchmark for 2017

November 12, 2015 | Health Insurance Exchanges | Comments
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This week, the Centers for Medicare and Medicaid Services (CMS) finalized Essential Health Benefits benchmark plans for 2017. The essential health benefits are the minimum coverage floor for health plans sold on the state and federal marketplaces, as well as Medicaid expansion plans. While each state determines its own essential benefits, all plans must include 10 categories of coverage – including mental health and substance use.
In August, the CMS office responsible for finalizing benchmark plans – the Center for Consumer Information and Insurance Oversight (CCIIO) – published a list of proposed benchmark plans for review and comment by states. The finalized plans incorporated comments and revisions from almost 20 states, including: Alaska, Arizona, California, Hawaii, Idaho, Kansas, Michigan, Missouri, Montana, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, South Carolina, South Dakota, Utah, Virginia, and Wyoming.


CCIIO published EHB benchmark information for states in a downloadable file. These files contain:

  • A summary of the state’s final 2017 EHB benchmark plan’s benefits and limits;
  • Supporting plan documents; and
  • Updated state-required benefits, if applicable, and any plans used to supplement the EHB benchmark plan.

For a complete breakdown of benchmark plans by state, click here.