Benefit Design Standards definition

Benefit Design Standards means coverage that provides for all of the following: 1.3.1. Essential Health Benefits as defined by OAR 836-053-0012; and 1.3.2. Cost-Sharing as described in 45 CFR 156.150.
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Benefit Design Standards means coverage that provides for all of the following: 1.4.1 Essential Health Benefits (EHBs) as defined by OAR 836-053-0012; 1.4.2 Cost-Sharing as described in 45 CFR 156.130; 1.4.3 A Level of Coverage as described in paragraph 1.25; and 1.4.4 Preventive services as required by ORS 743A.262 as amended by House ▇▇▇▇ 2282 (2023).
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Benefit Design Standards means coverage that provides for all of the following: 3.3.1 The Essential Health Benefits (EHBs) adopted by the State of Oregon pursuant to 45 CFR part 156 and section 1302(b) of the ACA; 3.3.2 Cost-Sharing as described in 45 CFR 156.130; and 3.3.3 A bronze, silver, gold, or platinum Level of Coverage as described in section 1302(d) of the Affordable Care Act, and (except for platinum coverage) in ORS 743.822 and Exhibit 1 to OAR 836-100-0200;
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Examples of Benefit Design Standards in a sentence

  • Carrier shall ensure that each of its SADPs complies with the Benefit Design Standards, including the actuarial value requirements and the pediatric dental component of federally approved EHBs.

  • Carrier will ensure that each of its QHPs complies with the Benefit Design Standards required by the ACA (Section 1302), including the Cost-Sharing limits, actuarial value requirements, and EHBs. Carrier may offer Catastrophic QHPs, which are exempt from the actuarial Level of Coverage requirement, as long as they meet other statutory provisions related to QHP design.

  • Carrier shall ensure that each of its QHPs complies with the Benefit Design Standards, including the Cost-Sharing limits, EHBs, and, except for Catastrophic QHPs, Level of Coverage requirements.

  • Benefit Design – Carrier shall ensure that each of its SADPs complies with the Benefit Design Standards required by the ACA (Section 1302), including the actuarial value requirements and the dental component of federally approved EHBs.


More Definitions of Benefit Design Standards

Benefit Design Standards means coverage that provides for all of the following:
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