Some dental carriers are worried that managers of the Covered California health insurance exchange could be colder in 2015, not warmer.
That possibility surfaced during a recent exchange board meeting.
Covered California managers alarmed some groups representing children this past summer when they adjusted dental benefits requirements for the insurers selling medical insurance through the exchange.
The Patient Protection and Affordable Care Act (PPACA) requires exchange plans to offer an “essential health benefits” (EHB) package that includes preventive pediatric dental benefits.
The U.S. Department of Health Human Services later decided that an exchange plan could leave dental benefits out of its EHB package if parents and guardians could buy stand-alone dental coverage through an exchange. Several big companies are now selling stand-alone dental coverage for kids through the exchange.
But children’s groups and other groups are now asking Covered California to encourage or require carriers to build the PPACA pediatric dental benefits into their basic benefits packages in 2015.
Board meeting witnesses said they fear that Covered California could go from one extreme — offering stand-alone plans and no embedded dental benefits — to the other extreme, with only embedded dental benefits and no stand-alone plans.
Eliminating stand-alone dental benefits could be a headache for small employers buying coverage through the exchange’s Small Business Health Options Program division, witnesses said.