Managers of HealthCare.gov have an early indicator of solid insurer interest in the 2017 open enrollment period: There is an increase in issuer interest in selling stand-alone dental plans (SADPs) through the insurance mall.
HealthCare.gov manages the plan menus for Patient Protection and Affordable Care Act (PPACA) individual exchange programs in 34 states.
In those 34 states, issuers have expressed an interest in a total of 161 SADP exchange relationships for the 2017 coverage year. A year ago, issuers were expressing an interest in having 141 SADP exchange relationships with HealthCare.gov for 2016.
HealthCare.gov is on track to run the Small Business Health Options Program (SHOP) exchange programs in 31 states for 2017, down from 32 this year. Meanwhile, carriers have expressed an interest in having 120 SADP group exchange relationships with HeallthCare.gov for 2017, up from 113 this year.
The U.S. Department of Health and Human Services (HHS) set up HealthCare.gov to handle PPACA exchange plan enrollment and administration in states that are unable or unwilling to do the job themselves.
HHS prepares the preliminary SADP issuer counts to help carriers comply with PPACA benefits requirements. PPACA normally requires the issuer of each major medical plan, or qualified health plan (QHP), sold through a PPACA exchange to offer dental benefits for children. If at least one dental insurer sells SADP coverage through a HealthCare.gov state’s exchange, then HHS lets the QHP issuers in that state leave the children’s dental benefits out of the benefits package.
HHS prepares the list only for the states in which it is in charge of their exchange plan menus. State-based exchanges, including some that now use HealthCare.gov systems because they had problems with their own systems, have their own separate strategies for handing the PPACA children’s dental coverage mandate.
Futhermore, the HHS definition of SADP’s “issuer” is complicated. In some cases, a parent company could own two or more separate issuers that sell SADPs in the same state. If one issuer sold SADPs through HealthCare.gov in three separate states, HHS would count that issuer as having three SADP exchange relationships, not just one.
HHS gets the preliminary SADP issuer counts through a voluntary notice program. Carriers that tell HHS they will sell SADPs through a state’s HealthCare.gov exchange in 2017 have no legal obligation to do so. It’s not easy to determine how the actual 2016 issuer counts compare with the numbers in the intent-to-offer table that HHS published a year ago.