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Essential Health Benefits (EHB)

The Affordable Care Act requires that health plans on the individual and small group market, including all plans sold on the exchanges, contain a package of items and services. Required care services include: emergency services, ambulatory patient services, maternity care, pediatric care, mental health care, laboratory services, prescription drugs, and others.

Community Rating

Setting premiums the same for all insurance applicants. “Modified community rating” refers to organizations changing premiums based on demographic characteristics, such as age, but cannot…