45 CFR §156.100
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
For plan years beginning before January 1, 2020, each State may identify a base-benchmark plan according to the selection criteria described below:
- (a)State selection of base-benchmark plan. The options from which a base-benchmark plan may be selected by the State are the following:
- (1)Small group market health plan. The largest health plan by enrollment in any of the three largest small group insurance products by enrollment, as defined in § 159.110 of this subpart, in the State's small group market as defined in § 155.20 of this subchapter.
- (2)State employee health benefit plan. Any of the largest three employee health benefit plan options by enrollment offered and generally available to State employees in the State involved.
- (3)FEHBP plan. Any of the largest three national Federal Employees Health Benefits Program (FEHBP) plan options by aggregate enrollment that is offered to all health-benefits-eligible federal employees under 5 USC 8903.
- (4)HMO. The coverage plan with the largest insured commercial non-Medicaid enrollment offered by a health maintenance organization operating in the State.
- (b)EHB-benchmark selection standards. In order to become an EHB-benchmark plan as defined in § 156.20 of this subchapter, a state-selected base-benchmark plan must meet the requirements for coverage of benefits and limits described in § 156.110 of this subpart; and
- (c)Default base-benchmark plan. If a State does not make a selection using the process described in this section, the default base-benchmark plan will be the largest plan by enrollment in the largest product by enrollment in the State's small group market.
- (d)Applicability date: For plan years beginning on or after January 1, 2020, § 156.111 applies in place of this section.