Kentucky Department of Insurance Statement on Recommendation for Benchmark Plan
Oct 2nd, 2012
Kentucky has recommended that the Anthem Preferred Provider Organization (PPO) plan serve as the “benchmark” plan for the Kentucky Health Benefit Exchange, as well as for plans offered outside the exchange. The Anthem PPO is the largest small group plan currently offered in Kentucky and includes coverage for all state mandates and the 10 essential health benefits, or categories of care, specified by the federal government under the Affordable Care Act.
The benchmark plan sets the minimum level of benefits offered in the individual and small group markets beginning Jan. 1, 2014.
The Anthem PPO plan is the most cost effective of the 10 plans reviewed, will not create additional costs for the state and should not increase the price for those who have coverage today. Since the Anthem PPO plan does not offer the minimum requirements for pediatric vision and dental services, Kentucky has recommended that the benefits in the Kentucky Children’s Health Insurance Program (KCHIP) be substituted in the benchmark plan.
The United States Department of Health and Human Services will review Kentucky’s recommendation for the essential health benefits and accept public comments prior to making a final decision.
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