What “essential health benefits” are included in the law and protected from annual limits?
The U.S. Department of Health and Human Services will determine which health benefits are “essential” and which can not be limited. All insures will have a better idea of what this means to their specific plans once HHS has published this listing.
Please explain how the internal and external appeals processes will be expanded.
We are awaiting further guidance from the U.S. Department of Health and Human Services on this issue. We believe our internal and external appeals processes will satisfy the new law's requirements.