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Washington Health Benefit Exchange DENTAL BENEFITS IN THE EXCHANGE - PowerPoint PPT Presentation

Nov 20, 2022 •172 likes •313 views

Washington Health Benefit Exchange DENTAL BENEFITS IN THE EXCHANGE Christine Gibert, Senior Policy Analyst DENTAL BENEFITS IN THE EXCHANGE Pediatric dental benefits: an ACA essential health benefit CHIP benchmark Qualifying

  1. Washington Health Benefit Exchange DENTAL BENEFITS IN THE EXCHANGE Christine Gibert, Senior Policy Analyst

  2. DENTAL BENEFITS IN THE EXCHANGE ▪ Pediatric dental benefits: an ACA “essential health benefit” ▪ CHIP benchmark ▪ “Qualifying children” ▪ Through age 18 ▪ 300+% FPL 2

  3. DENTAL BENEFITS IN THE EXCHANGE ▪ Washington legislation HB 2319 ▪ “Offered and priced separately” ▪ Stand-alone dental plans in Individual Exchange ▪ Currently embedded dental benefits in SHOP ▪ Mandatory purchase ▪ Limited system functionality and shopping experience ▪ Tax credits ▪ Plan comparison features 3

  4. DENTAL CARRIERS IN THE INDIVIDUAL MARKET Company Name AFLAC Delta Dental of Washington Dental Health Services Dentegra Humana LifeMap Assurance Company Regence BlueShield Starmount Life United Concordia UnitedHealthOne Dental Insurance Plan Willamette Dental Source: http://www.insurance.wa.gov/your-insurance/health-insurance/individuals-families/dental/ 4

  5. DENTAL CARRIERS IN THE EXCHANGE Company Name Delta Dental of Washington Dental Health Services Kaiser Permanente LifeWise Health Plan of WA Premera Blue Cross 5

  6. POSSIBLE FUTURE CHANGES ▪ “Mandatory purchase” requirement ▪ QHPs with embedded dental benefits ▪ Adult and family dental products 6

  7. POSSIBLE CHANGES: MANDATORY PURCHASE ▪ “Mandatory purchase” requirement ▪ Concern: families with double dental coverage ▪ Board could reconsider ▪ Reasonable assurance of other dental coverage ▪ Would align with the outside market ▪ Significant changes to Healthplanfinder 7

  8. POSSIBLE CHANGES: EMBEDDED DENTAL ▪ Current HB 2467 ▪ Removes “priced and offered separately” requirement ▪ Allows stand-alone plans as well as dental benefits embedded in health plans in the Exchange ▪ Effective in 2016 8

  9. POSSIBLE CHANGES: EMBEDDED DENTAL ▪ Stand-alone dental plans and embedded dental benefits in the Exchange ▪ Consumer choice ▪ Aligns with outside dental market ▪ Significant changes to Healthplanfinder ▪ Comparison of stand-alone dental plans and QHPs with embedded dental ▪ Complex shopping experience 9

  10. POSSIBLE CHANGES: ADULT DENTAL ▪ Allow adult shoppers to buy their own dental plans and families to buy family dental plans that include the pediatric dental EHB ▪ Significant changes to Healthplanfinder ▪ Shopping “flow” ▪ Shopping experience ▪ Individual and SHOP markets ▪ Possible for 2016 10

  11. TIMELINE FOR DENTAL CHANGES – 2016 COVERAGE ▪ Throughout 2014 - Update Healthplanfinder system to offer enhanced dental options in Individual and SHOP markets ▪ Mid to late 2014 - Carriers begin developing plans ▪ February 2015 - Carriers begin submitting filings to OIC ▪ May – July 2015 - WAHBE review of plans and Board certification process ▪ October 2015 – Open Enrollment begins for 2016 coverage ▪ January 2016 – Enhanced dental coverage begins 11

  12. CHALLENGES OF ENHANCED DENTAL OPTIONS ▪ Significant changes to the Healthplanfinder system ▪ Timeline for implementation 12

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