TABLE C-1 Reported Frequency of Benefit Coverage

Category (Section 1302 category shaded in grey)a [Note: organization of table does not endorse classification of service into category] DOL 2011 (%)b BLS 2009 Large Employer(%)c BLS 2009 Small Employer (%)d Mercer 2009 Large(%)e Mercer 2009 Small (%)f Mercer 2011 All (%)g Maryland’s Standard Health Benefit Plan Requirements for Small Businesses (MHCC, 2011)
Ambulatory patient services
Kidney dialysis 27%h 95%
Outpatient facility charges 98%. Covered (outpatient hospital services)
Outpatient surgery 97% 98% Covered
Physician office visits 100% 100% 100%
Urgent care facility services
Allergy testing and injections
Emergency services
Ambulance services 64%i Covered
Emergency room visits 91%j Covered
Hospitalization
Hospital room and board 99% 99% 100% Covered (hospitalization)
Inpatient surgery 98% 99%
Organ and tissue transplantation 45%k 95%. (organ transplants) Covered (for bone marrow, cornea, kidney, liver, lung, heart, heart-lung, pancreas, and pancreas-kidney transplants)
Maternity and newborn care
Maternity care 66%l Covered (pregnancy and maternity)
Mental health and substance use disorder services, including behavioral health treatment
Autism services 80%. 69%
Applied behavioral analysis for autism 50%
Speech, occupational, and physical therapies for autism 61%


The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement