Digging in to Benchmark Plan Details

Eager to dig into details about state benchmark plan choices so far? This chart provides key details—with direct links to evidence of coverage documents and CCIIO’s plan summaries—about the plans states have selected or defaulted into. States had until December 26, 2012 to submit comments on the proposed EHB regulations to finalize their benchmark plan decision. For background, see our blog post.
Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. State Refor(u)m captures the health reform comments, documents, and links submitted by health policy thinkers and doers all over the country. And our team periodically supplements, analyzes, and compiles this key content.
Know of something, like an additional evidence of coverage document, we should add to this compilation? Eager to update a fact we’ve included? Your feedback is central to our ongoing, real-time analytical process, so tell us in a comment below, or email the author with your suggestion. She can be reached at ksheedy@oldsite.nashp.org.
*Chart updated on February 5, 2014

State	Recommendation to HHS	Small Group	Largest HMO	State Employee	National FEHBP	Default	Evidence of Coverage	CCIIO Plan Summaries	Pediatric Vision	Pediatric Oral
	Selection of a benchmark plan whose benefits will largely define “essential health benefits”	HHS Bulletin, FAQ and final regulations defined options from which states could choose a benchmark plan				If a state does not choose a plan, its benchmark is set by default as the largest small group market product in the state’s small group market	The Benchmark plan’s coverage details and contract with policyholders	Benchmark plan’s summary available atCCIIO	HHS requires benchmark plans to meet all 10 essential health benefit categories including pediatric vision and oral health care services. Many existing commercial plans do not offer pediatric vision or pediatric dental, so states are required to choose a supplemental plan that covers these services.
AL	Blue Cross Blue Shield of Alabama PPO 320 Plan					X	X	X	FEDVIP	FEDVIP
AK	Premera Blue Cross Blue Shield of Alaska Heritage Select Envoy PPO					X		X1	FEDVIP	FEDVIP
AZ	Arizona Benefit Options EPO Plan, administered by United HealthCare			X			X	X	FEDVIP	FEDVIP
AR	HMO Partners, Inc. Open Access POS, 13262AR001	X					X	X2	FEDVIP	CHIP
CA	Kaiser Foundation Health Plan Small Group HMO 30 ID 40513CA035	X					X	X		CHIP
CO	Kaiser Foundation Health Plan of Colorado Ded HMO 1200D	X					X	X		CHIP
CT	ConnectiCare HMO		X				X	X	FEDVIP	CHIP
DE	Highmark Blue Cross Blue Shield Delaware  Simply Blue EPO 100 500	X						X	FEDVIP	CHIP
DC	Group Hospitalization and Medical Services, Inc. BluePreferred PPO	X					X	X	FEDVIP	FEDVIP
FL	Blue Cross Blue Shield of Florida, Inc. BlueOptions 5462 PPO					X		X	FEDVIP	FEDVIP
GA	Blue Cross Blue Shield of Georgia HMO Urgent Care 60 Copay					X		X	FEDVIP	FEDVIP
HI	Hawaii Medical Service Association  Preferred Provider Plan 2010	X					X	X	FEDVIP	CHIP
ID	Blue Cross of Idaho Health Service, Inc. Preferred Blue PPO					X		X	FEDVIP	FEDVIP
IL	Blue Cross and Blue Shield of Illinois BlueAdvantage PPO	X					X	X	FEDVIP	CHIP
IN	Anthem Blue Cross and Blue Shield of Indiana Blue 5 Blue Access PPO Medical Option 6 Rx Option G					X		X	FEDVIP	FEDVIP
IA	Wellmark Inc. Alliance Select Copayment Plus PPO					X	X	X	FEDVIP	FEDVIP
KS	Blue Cross and Blue Shield of Kansas Comprehensive Major Medical Blue Choice PPO GF 500 deductible with Rx card	X					X	X	CHIP3	CHIP3
KY	Anthem Health Plans of Kentucky, Inc. PPO	X					X	X		CHIP
LA	Blue Cross and Blue Shield of Louisiana GroupCare PPO					X		X	FEDVIP	FEDVIP
ME	Anthem Health Plans of Maine Blue Choice 20 PPO with RX 10 30 50 5					X		X		FEDVIP
MD	CareFirst BlueChoice HMO HSA Open Access Plan4			X				X	FEDVIP	CHIP
MA	Blue Cross and Blue Shield of Massachusetts, Inc. HMO Blue, 2000 Deductible	X					X	X		CHIP
MI	Priority Health PriorityHMO100 Percent Hospital  Services Plan		X				X	X	FEDVIP	CHIP
MN	HealthPartners 500 25 Open Access PPO					X		X	FEDVIP	FEDVIP
MS	Blue Cross and Blue Shield of Mississippi Network Blue PPO	X					X	X	FEDVIP	CHIP
MO	Healthy Alliance Life Insurance Co. (Anthem BCBS) Blue 5 Blue Access PPO Medical Option 4 Rx Option D					X		X	FEDVIP	FEDVIP
MT	Blue Cross and Blue Shield of Montana Blue Dimensions PPO					X		X	FEDVIP	FEDVIP
NE	Blue Cross and Blue Shield of Nebraska BluePride PPO					X		X	FEDVIP	CHIP
NV	Health Plan of Nevada Point Of Service Group 1 C XV 500 HCR	X					X	X	FEDVIP	CHIP
NH	Matthew Thornton  Health Plan (Anthem BCBS) HMO Blue New England 25 50 WITH Rx 10 35 30 OOP 2500	X						X	FEDVIP	FEDVIP
NJ	Horizon HMO Access HSA Compatible		X5					X	FEDVIP	CHIP4
NM	Lovelace Insurance Company Classic PPO	X						X		CHIP
NY	Oxford Health Insurance, Inc. Oxford EPO	X						X		CHIP
NC	Blue Cross and Blue Shield of North Carolina Blue Options PPO					X	X	X	FEDVIP	FEDVIP
ND	Sanford Health Plan HMO		X				X	X	CHIP	CHIP
OH	Community  Insurance Company (Anthem BCBS) Blue 6 Blue Access PPO Medical Option D4 Rx Option G					X		X	FEDVIP	FEDVIP
OK	Blue Cross and Blue Shield of Oklahoma BlueOptions PPO RYB05					X		X	FEDVIP	CHIP
OR	PacificSource Health Plans PPO Preferred CoDeduct Value 3000 35 70	X					X	X	FEDVIP	CHIP
PA	Aetna Health, Inc. PA POS Cost Sharing 34 1500 Ded					X		X		FEDVIP
RI	Blue Cross and Blue Shield of Rhode Island Vantage Blue PPO	X					X	X	FEDVIP	FEDVIP
SC	Blue Cross Blue Shield of South Carolina Business Blue Complete PPO					X	X	X	FEDVIP	FEDVIP
SD	Wellmark of South Dakota Blue Select PPO	X						X	FEDVIP	FEDVIP
TN	Blue Cross Blue Shield of Tennessee PPO					X		X	FEDVIP	FEDVIP
TX	Blue Cross Blue Shield of Texas BestChoice  PPO RS26					X		X	FEDVIP	FEDVIP
UT	Public Employee’s Health Program Utah Basic Plus			X			X	X
VT	The Vermont Health Plan, LLC, CDHPHMO		X				X	X	FEDVIP	CHIP
VA	Anthem Small Group PPO	X						X	FEDVIP	CHIP
WA	Regence BlueShield nongrandfathered small group product	X					X	X	FEDVIP	CHIP
WV	Highmark Blue Cross Blue Shield West Virginia Super Blue PPO Plus 2000 1000 Ded					X		X	FEDVIP	CHIP
WI	UnitedHealthcare Insurance Company Choice Plus Definity HSA Plan A92NS					X		X	FEDVIP	FEDVIP
WY	Blue Cross Blue Shield of Wyoming Blue Choice Business 1000 80 20					X		X	FEDVIP	FEDVIP
Total		20	5	3	0	23	24		42 FEDVIP, 2 CHIP, 7 Included	26 FEDVIP, 24 CHIP, 1 Included

 
Notes
¹Alaska supplemented their plan with FEHBP.
²Arkansas supplemented their plan with FEHBP.
³In their comment letter to HHS on the final interim rule for standards related to essential health benefits, Kansas revised their supplemental pediatric vision and oral plans to the Kansas Children’s Health Insurance Plan (CHIP) benefits.
⁴Maryland revised its EHB Benchmark Plan selection.
⁵New Jersey chose the largest HMO plan to serve as their EHB benchmark and designated NJ FamilyCare (CHIP) as the supplemental pediatric oral plan.
 
Chart produced by: Jade Christie-Maples and Kaitlin Sheedy