Dental plans are asking the National Association of Insurance Commissioners to think about them when it is helping to set up the new health insurance exchanges.
Kathryn Paul, chair of the Health Care Reform Implementation Task Force at the Delta Dental Plans Association, Oak Brook, Ill., hopes to testify on behalf of the association Friday at a hearing organized by the NAIC’s Exchanges Subgroup.
The NAIC, Kansas City, Mo., organized the subgroup to help with implementation of the health insurance exchange provisions of the Patient Protection and Affordable Care Act (PPACA), a component of the federal Affordable Care Act package.
One Delta Dental goal is to give individuals and small employers who use the exchange system the freedom to choose whether to buy dental coverage and major medical coverage from the same carrier or from separate carriers.
“The purchase of medical benefits should be separate from the purchase of dental coverage, and forced tie-in sales should not be allowed,” Paul says in a written version of her testimony posted on the Exchanges Subgroup’s section of the NAIC website.
Republicans are trying to block implementation of PPACA and the rest of the Affordable Care Act. If PPACA takes effect as written, the health insurance exchange provisions will create new entities that will help individuals, families and small groups use new federal income tax subsidies to shop for health coverage.
A state can set up one exchange or several exchanges for its residents, and it also can decide to let residents participate in a multi-state exchange.
The “qualified health plans” sold through the exchanges will have to offer what the U.S. Department of Health and Human Services (HHS) decides is “minimum essential benefits.”
All major medical carriers, inside and outside the exchanges, will have to sell coverage on a guaranteed-issue, mostly community-rated basis, without using health status to decide whether to
issue coverage or set rates.
Individuals who want to meet Affordable Care Act health coverage requirements and avoid paying penalties will have to have a minimum level of pediatric dental coverage for their children, and carriers that sell qualified health plans through the exchanges will have to provide that minimum level of pediatric dental benefits.