Code of Federal Regulations (Last Updated: November 8, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter D - State Children'S Health Insurance Programs (Schips) |
Part 457 - Allotments and Grants to States |
Subpart D - State Plan Requirements: Coverage and Benefits |
§ 457.420 - Benchmark health benefits coverage.
Latest version.
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§ 457.420 Benchmark health benefits coverage.
Benchmark coverage is health benefits coverage that is substantially equal to the health benefits coverage in one of the following benefit plans:
(a) Federal Employees Health Benefit Plan (FEHBP). The standard Blue Cross/Blue Shield preferred provider option service benefit plan that is described in, and offered to Federal employees under, 5 U.S.C. 8903(1).
(b) State employee plan. A health benefits plan that is offered and generally available to State employees in the State.
(c) Health maintenance organization (HMO) plan. A health insurance coverage plan that is offered through an HMO (as defined in section 2791(b)(3) of the Public Health Service Act) and has the largest insured commercial, non-Medicaid enrollment in the State.