---
kind: "section"
citation: "42 C.F.R. § 600.405"
title: "42"
number: "600.405"
heading: "Standard health plan coverage."
url: "https://uscodex.org/cfr/42/600.405"
---

# §600.405. Standard health plan coverage.

- (a) **Essential Health Benefits (EHB).** Standard health plan coverage must include, at a minimum, the essential health benefits as determined and specified under 45 CFR [156.110](/cfr/45/156.110.md), and [45](/cfr/45/45.md) CFR 156.122 regarding prescription drugs, except that States may select more than one base benchmark option from those codified at [45 CFR 156.100](/cfr/45/156.100.md) for establishing essential health benefits for standard health plans. Additionally, States must comply with [45 CFR 156.122(a)(2)](/cfr/45/156.122.md?p=a-2) by requiring participating plans to submit their drug list to the State.
- (b) **Additional required benefits.** Where the standard health plan for BHP is subject to State insurance mandates, the State shall adopt the determination of the Exchange at [45 CFR 155.170(a)(3)](/cfr/45/155.170.md?p=a-3) in determining which benefits enacted after December 31, 2011 are in addition to EHB.
- (c) **Periodic review.** Essential health benefits must include any changes resulting from periodic reviews required by [section 1302(b)(4)(G)](/cfr/42/1302.md?p=b-4-G) of the Affordable Care Act. The provision of such essential health benefits must meet all the requirements of [45 CFR 156.115](/cfr/45/156.115.md).
- (d) **Non-discrimination in benefit design.** The terms of [45 CFR 156.125](/cfr/45/156.125.md) applies to standard health plans offered under the BHP.
- (e) **Compliance.** The State and standard health plans must comply with prohibitions on federal funding for abortion services at [45 CFR 156.280](/cfr/45/156.280.md).

## Notes

### Authority

Authority: 42 U.S.C. 300gg, 1395, and 18051.

### Source

Source: 79 FR 14140, Mar. 12, 2014, unless otherwise noted.