In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.
Issuer Essential Health Benefits Crosswalk and Certification
Georgetown University Health Policy Institute
The Issuer Essential Health Benefits (EHB) Crosswalk and Certification has been developed by the Georgetown University Health Policy Institute to help insurance regulators ensure that product filings include the required EHBs as set forth in the applicable state benchmark plan. Regulators can use the tool provided here, requiring issuers to complete the Crosswalk and Certification by: (i) describing each benefit as set forth in the state’s benchmark plan (including applicable page numbers); (ii) describing the corresponding benefit in the issuer’s product filing (including applicable page numbers); and (iii) certifying that (a) the information in the Crosswalk and Certification is accurate and complete and (b) the product filing includes all required essential health benefits as set forth in the state’s benchmark plan. The issuer completed Crosswalk and Certification is intended to increase the efficiency of the form review process by allowing form reviewers to quickly find and verify that the product under review meets all applicable EHB requirements. The tool is word document format and is designed to be modified to meet state-specific needs.