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Perspectives on Essential Health Benefits Workshop Report (2012) / Chapter Skim
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Appendix A: Patient Protection and Affordable Care Act, Section 1302
Pages 157-160

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 157...
... (a) ESSENTIAL HEALTH BENEFITS PACKAGE. -- In this title, the term "essential health benefits package" means, with respect to any health plan, coverage that -- (1)
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From page 158...
... ensure that health benefits established as essential not be subject to denial to individuals against their wishes on the basis of the individuals' age or expected length of life or of the individuals' present or predicted disability, degree of medical dependency, or quality of life; (E) provide that a qualified health plan shall not be treated as providing coverage for the essential health benefits described in paragraph (1)
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From page 159...
... in the case of self-only coverage, be equal to the dollar amount under subparagraph (A) for self only coverage for plan years beginning in 2014, increased by an amount equal to the product of that amount and the premium adjustment percentage under paragraph (4)
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From page 160...
... (C) APPLICATION. -- In determining under this title, the Public Health Service Act, or the Internal Revenue Code of 1986 the percentage of the total allowed costs of benefits provided under a group health plan or health insurance coverage that are provided by such plan or coverage, the rules contained in the regulations under this paragraph shall apply.
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Key Terms

  • essential health
  • health plan
  • qualified health
  • platinum level
  • actuarial value

  • benefits described
  • benefits provided
  • revenue code
  • internal revenue
  • provide benefits

  • health insurance
  • actuarially equivalent
  • plan offered
  • individual market
  • evidence base

  • annual limitation
  • contractual relationship
  • plan described
  • emergency department
  • department services

  • plan provides
  • expected length
  • patient services
  • spending arrangement
  • catastrophic plan

  • establish incentive
  • benefits requirements
  • health center
  • benefits reflect
  • benefits defined


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