45 C.F.R. § 147.150

Coverage of essential health benefits

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(a) Requirement to cover the essential health benefits package. A health insurance issuer offering health insurance coverage in the individual or small group market must ensure that such coverage includes the essential health benefits package as defined in section 1302(a) of the Affordable Care Act effective for plan or policy years beginning on or after January 1, 2014.

(b) Cost-sharing under group health plans. [Reserved]

(c) Child-only plans. If a health insurance issuer offers health insurance coverage in any level of coverage specified under section 1302(d)(1) of the Affordable Care Act, the issuer must offer coverage in that level as a plan in which the only enrollees are individuals who, as of the beginning of a plan year, have not attained the age of 21.

[78 FR 12865, Feb. 25, 2013]

Notes of Decisions

Cited in 1 case, 2020–2020 · leading case: Andrea Schmitt v. Kaiser Found. Health Plan, 965 F.3d 945 (9th Cir. 2020).

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Andrea Schmitt v. Kaiser Found. Health Plan, 965 F.3d 945 (9th Cir. 2020). “§ 300gg- 6(a); see also 45 C.F.R. § 147.150 (a) (“A health insurance issuer offering health insurance coverage in the individual or small group market must ensure that such coverage includes the essential health benefits package .”

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