include this benefit in establishing the health plan's actuarial value. Maternity and Requirement 42 USC Plan must "maternity and newborn services" in a manner Newborn to cover §18021 substantially equal to the base-benchmark plan. For purposes of Services (EHB) Maternity and (a)(1)(B); determining a plan's actuarial value, an issuer must classify as Newborn 42 USC maternity and newborn services the medically necessary care and Services 18022 services delivered to women during pregnancy and in relation to (b)(1)(D) delivery and recovery from delivery and to newborn children. WAC 284-43-5642(4) Required Plan must the following services which are specifically covered WAC Maternity and by the base-benchmark plan and classify them as maternity and Newborn newborn services: (4)(a)(i) Services In utero treatment for the fetus; (4)(a)(ii) Vaginal or cesarean childbirth delivery in a hospital or birthing center, including facility fees; (4)(a)(iii) Nursery services and supplies for newborns, including newly adopted children; (4)(a)(iv) Infertility diagnosis; (4)(a)(v) Prenatal and postnatal care and services, including screening; Required WAC Complications of pregnancy such as, but not limited to, fetal Maternity and Maternity and distress, gestational diabetes, and toxemia; and Newborn Newborn (4)(a)(vi) Services (EHB) Services WAC Termination of pregnancy. Termination of pregnancy may be (Cont’d) (Con’td) included in an issuer's essential health benefits package, but (4)(a)(vii) nothing in this section requires an issuer to offer the benefit, consistent with 42 U.S.C. 18023 (b)(a)(A)(i) and 45 C.F.R. 156.115.
include this benefit in establishing the health plan's actuarial value. Maternity and Newborn Services (EHB) Maternity and Newborn Services (EHB) (Cont’d) Requirement to cover Maternity and Newborn Services 42 USC §18021 (a)(1)(B); 42 USC 18022 (b)(1)(D) Plan must "maternity and newborn services" in a manner substantially equal to the base-benchmark plan. For purposes of determining a plan's actuarial value, an issuer must classify as maternity and newborn services the medically necessary care and services delivered to women during pregnancy and in relation to delivery and recovery from delivery and to newborn children. WAC 284-43-5642(4) Required Maternity and Newborn Services Required Maternity and Newborn Services (Con’td) WAC (4)(a)(i) Plan must the following services which are specifically covered by the base-benchmark plan and classify them as maternity and newborn services: In utero treatment for the fetus; (4)(a)(ii) Vaginal or cesarean childbirth delivery in a hospital or birthing center, including facility fees; (4)(a)(iii) Nursery services and supplies for newborns, including newly adopted children; (4)(a)(iv) Infertility diagnosis; (4)(a)(v) Prenatal and postnatal care and services, including screening; WAC (4)(a)(vi) Complications of pregnancy such as, but not limited to, fetal distress, gestational diabetes, and toxemia; and WAC (4)(a)(vii) Termination of pregnancy. Termination of pregnancy may be included in an issuer's essential health benefits package, but nothing in this section requires an issuer to offer the benefit, consistent with 42 U.S.C. 18023 (b)(a)(A)(i) and 45 C.F.R. 156.115.