This practice note explains the rules related to essential health benefits (EHB) under the Patient Protection and Affordable Care Act (Pub. L. No. 111-148), as amended by the Health Care and Education Reconciliation Act (Pub. L. No. 111-152) (ACA). EHB are specific health plan benefits, as designated by each state under ACA rules, that represent a package of comprehensive insurance coverage that certain health plans must provide, including qualified health plans (QHPs) offered on an ACA exchange and all small group plans and individual policies offered by insurers. Large group plans and self-insured plans are generally exempt from mandatory coverage of EHB. However, an EHB analysis is also important for the broader range of plans that are subject to the ACA's cost sharing rules and to calculate a plan's actuarial value of benefits and metal rating (bronze, silver, gold, or platinum). Benefits practitioners need to be familiar with these rules to advise their clients on compliance and ...