GRAND RAPIDS, Mich.--(Michigan’s Essential Health Benefits Benchmark Plan: Executive Report, recommending Priority Health’s HMO plan be selected as Michigan’s essential health benefits (EHB) benchmark plan beginning Jan. 1, 2014. OFIR endorsed Priority Health’s plan as a framework for all individual and small group plans in Michigan due to its low-cost yet all-inclusive service options.)--The Michigan Office of Financial & Insurance Regulation (OFIR) has released the
“Priority Health continues to earn recognition for its ability to create innovative solutions that impact health care costs while maximizing customer experience.”
“To be recommended as a benchmark plan for the entire state underscores Priority Health’s ability to deliver an incredible value to its customers,” said Michael P. Freed, president and CEO for Priority Health. “Priority Health continues to earn recognition for its ability to create innovative solutions that impact health care costs while maximizing customer experience.”
Under the Patient Protection and Affordable Care Act, starting in 2014, each state will need a benchmark plan as a reference for scope of services and limits offered by a health plan. In addition to selecting Priority Health’s plan as providing the highest value, OFIR chose the plan because it will:
- Help lessen rate increases that will occur because of the EHB requirement
- Minimize the impact of the EHB on consumers
- Provide a broad range of benefits in each of the 10 EHB categories, including emergency services, prescription drugs, preventive and wellness services, hospitalization and laboratory services
The written recommendation explained, “OFIR recommends that the Priority Health HMO plan be selected as Michigan’s benchmark plan. This plan is the lowest-cost benchmark plan option, which will provide an excellent framework for all individual and small group plans offered in Michigan after January 1, 2014.”
The report continued, “OFIR believes that the selection of Priority Health’s HMO plan achieves the best balance between comprehensiveness and cost-effectiveness for Michigan consumers.”
Two studies were conducted to select the highest-value plan: an OFIR internal analysis and a benefits and cost analysis of the plan choices by an actuarial consulting group. Each of the plans was assessed on multiple features, such as whether it included all 10 categories of EHBs after supplementation as well as coverage for all Michigan-mandated services; provided comprehensive coverage while maintaining affordability; and minimized the impact of increased rates on consumers. In addition, factors including consumer and other stakeholder input, scope and duration of limitations for covered benefits, and consumer demand for particular plans were considered.
About Priority Health
Priority Health is an award-winning health plan nationally recognized for creating innovative solutions that impact health care costs while maximizing customer experience. It offers a broad portfolio of products for employer groups and individuals, including Medicare and Medicaid beneficiaries. As a nonprofit company, Priority Health serves more than 600,000 people and continues to be rated among the best health plans in the nation by the National Committee for Quality Assurance. For more information visit priorityhealth.com.