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Essential health benefits are categories of health care services that must be covered by all non-transitional small group qualified health plans.
EHBs are determined on a state-by-state basis. Michigan’s EHB categories are:
No. Large groups with fully insured, self-funded and grandfathered plans are not required to cover EHBs.
QHPs are Affordable Care Act-compliant plans that, in addition to covering EHBs, must follow established limits on cost-sharing. They are grouped into metal tiers based on the percentage of health care costs the plans cover.