The state of Colorado has notified the federal government it has selected the as its 2017 benchmark plan representing essential health benefits, officials said Tuesday.
The selection doesn’t mean that everyone will have to become Kaiser customers, Division of Insurance officials said. The benefits in the benchmark plan simply serve as , as a minimum, in all individual and small-group plans offered in Colorado in 2017 and beyond.
Health insurance carriers can still develop their own plan designs, which may include additional benefits.
The plan selection doesn’t determine how costs for health services are shared between individuals and the insurance company, DOI officials said. Carriers still have the flexibility to develop how costs are shouldered through deductibles, co-payments and co-insurance amounts. In addition, each carrier will still use its own provider network.
To be eligible for selection as a state benchmark, a health plan had to provide coverage in almost all identified in the Affordable Care Act: outpatient, emergency room, inpatient, prenatal and newborn, mental health, prescriptions, lab tests, rehabilitation therapies, comprehensive pediatric services (medical, dental, vision), vaccines and preventive care, including contraception.
The Kaiser State Employee Plan does not provide coverage of pediatric dental benefits, so the state is supplementing the selected plan with pediatric dental benefits contained in the state’s Child Health Plan Plus Dental Program.
