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Bill - HR3200

This Document was obtained from The Library of Congress Thomas System as of July 14th, 2009

ESSENTIAL BENEFITS PACKAGE- The term essential benefits package is defined in section 122[a].

Section- 122[a]

IN GENERAL.—In this division, the term essential benefits package means health benefits coverage, consistent with standards adopted under section 124 to ensure the provision of quality health care and financial security, that—

  1. provides payment for the items and services described in subsection (b) in accordance with generally accepted standards of medical or other appropriate clinical or professional practice;
  2. limits cost-sharing for such covered health care items and services in accordance with such benefit standards, consistent with subsection (c);
  3. does not impose any annual or lifetime limit on the coverage of covered health care items and services;
  4. complies with section 115(a) (relating to network adequacy); and
  5. is equivalent, as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services, to the average prevailing employer-sponsored coverage.

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