When Open Enrollment for 2015 health insurance plans begins on November 15, 2014, it will be nice to NOT have to explain to individual and small group clients why they must pay for pediatric dental benefits even if they have no children on their policy.
It’s not that we are anti-pediatric-dental-care! We love healthy teeth in kids as much as the next guy!
The Trouble with Pediatric Dental Benefit in 2014 Plans
For 2014 plans purchased outside the Exchange, ALL individual and small group plans HAD TO include coverage for pediatric dental care — even in the case where there were no children on the policy.
To make matters worse, the pediatric dental coverage embedded into 2014 health plans in many cases was not robust enough to adequately cover any kids actually on the plan. In addition, coverage often did not kick in until after the medical deductible had been met.
And, of course, there was no way to avoid paying the additional premium associated with the unneeded or unwanted coverage.
Honestly, it was somewhat of a mess!
We found ourselves recommending to our clients who needed adequate dental coverage for their children that they go ahead and add a stand-alone dental plan to their coverage, despite being charged a premium for the mandated coverage.
New Laws for 2015
Last March, the Virginia Assembly passed two important bills into law — HB33 and SB484 — which do away with 2014’s difficult situation regarding pediatric dental coverage in Virginia.
According to these laws, for coverage effective January 1, 2015 and later, health insurance carriers are NOT required to include pediatric dental benefits in individual or small group (50 or fewer employees) health insurance plans in Virginia as long as:
- There is at least one dental plan available for purchase that offers the minimum essential pediatric dental benefits, AND
- The insurance carrier discloses that essential pediatric dental benefits are not included in the plan.
Since there are several dental carriers who offer certified plans in Virginia, there will be no need for health insurance carriers to include pediatric dental benefit in their 2015 Virginia health plans. Interestingly, we are seeing many carriers still including that coverage in their 2015 plans, but not charging extra for it.
This is good news!
Virginia residents will no longer be forced into paying for coverage they don’t need or that does not adequately meet their needs.
Finding the Right Coverage for 2015
Remember, Open Enrollment for 2015 health insurance runs from November 15, 2014 through February 15, 2015. During these dates, you can choose a new health insurance plan for 2015.
We will be happy to get you set up with a health insurance plan — perhaps coupled with a stand-alone dental plan — that works for you and your family, or in the case of small business owners, your employees.
Give us a call at 1-800-867-0800 or send us an email at jkatz@vamedicalplans.com.
Please be patient as we are experiencing a high volume of calls and emails.
