Selected Medical Benefits: Patient Protection and Affordable Care Act of 2010 United States Department of Labor Author
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The Patient Protection and Affordable Care Act of 2010 states that the Secretary [of Health and Human Services] shall define the essential health benefits for certain health plans. The Act further instructs the Secretary to ensure that the scope of the essential health benefits ... is equal to the scope of benefits provided under a typical employer plan. The Act requires the Secretary of Labor to conduct a survey of employer-sponsored coverage to determine the benefits typically covered by employers, and to report the results of the survey to the Secretary of Health and Human Services. To meet its requirement, the Department of Labor (DOL) first looked to its ongoing survey of benefits-the Bureau of Labor Statistics (BLS) National Compensation Survey (NCS). The NCS, a survey of employers, provides comprehensive data on employment-based health care benefits. Annually, data from this survey are released on the percent of employees offered employment-based health care benefits and the percent of employees who are actually covered by such benefits. Further details on the provisions of those health care plans, including what services are covered and what cost-sharing is required by plan participants, are published periodically. While the NCS currently captures data from about 36,000 employers, including those in private industry and State and local government across all industries and all establishment sizes, information on the detailed provisions of employment-based health care benefits is from a representative sample of about 3,900 private sector employers annually. From each of these employers, BLS identifies available health plans and requests copies of written documents describing plan benefits. These documents vary widely: some may be formal Summary Plan Descriptions and provide comprehensive information; others may be short summaries or comparison charts that are much less comprehensive. BLS extracted the detailed plan provisions presented in this report from approximately 3,200 plan documents.


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