45 CFR § 155.170 - Additional required benefits.
(a) Additional required benefits.
(1) A State may require a QHP to offer benefits in addition to the essential health benefits.
(2) A benefit required by State action taking place on or before December 31, 2011 is considered an EHB. A benefit required by State action taking place on or after January 1, 2012, other than for purposes of compliance with Federal requirements, is considered in addition to the essential health benefits.
(c) Cost of additional required benefits.
(2) A QHP issuer's calculation shall be:
(i) Based on an analysis performed in accordance with generally accepted actuarial principles and methodologies;
(ii) Conducted by a member of the American Academy of Actuaries; and
(iii) Reported to the State.
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