According to buzz within the brokerage community, to meet minimum actuarial value, using the government’s own actuarial calculator, you can eliminate in-patient hospital coverage and remain within the definition. MEC plans and now this. What other “gems” can be found in PPACA? Pelosi was dead on – “We have to pass the bill so that you can find out what’s in it!”
FROM A STOP LOSS CARRIER REP:
If fully insured, isn’t the calculator a moot point because hospitalization is an essential health benefit?
If self funded, EHBs aren’t required so I’d have to play with the calculator to verify (if it’s even possible to eliminate IP hospital within the calculator). I can tell you that when I played with the calculator when it was released, I found it was pretty tough to not meet the minimum value.