07/23/2013

Dental plans participating in Health Exchange selected


Covered California, the health and dental insurance online marketplace created by the Affordable Care Act (ACA), has announced the dental plans that will be available for purchase through the Exchange. 

Six plans were chosen:

  • Anthem Dental;
  • Blue Shield of California;
  • Delta Dental of California;
  • Health Net Dental;
  • LIBERTY Dental Plan; and
  • Premier Access Dental.

A booklet covering in detail the dental plan offerings, including the premium rates, can be found on the Covered California website.

“The California Dental Association is pleased that Covered California is providing a variety of pediatric dental plan options for families to purchase. Permitting dental plans to offer coverage in the Exchange allows for more consumer choice, offers greater transparency in pricing and gives families the best opportunity to keep their provider of choice,” said CDA President Lindsey Robinson, DDS.

Not all selected plans will be offering coverage in all counties, but most counties will have at least five plans available to consumers. The products that will be offered include stand-alone plans, and all can be bundled with health insurance for a single premium. Three different product types are available in most regions: dental health maintenance organizations (DHMOs), dental preferred provider organizations (DPPOs) and dental exclusive provider organizations (DEPOs).

The amount of the premium paid by consumers varies slightly from region to region, but generally, premiums are $10-$15 for DMHOs and $20-$40 for DPPOs and DEPOs. The rates each plan will pay to providers are not included. 

Since Covered California has opted to be an active purchaser in the development of the Exchange, the pediatric dental plans underwent a rigorous and competitive bidding process and “had to balance access to providers with affordable premiums to qualify,” according to an Exchange press release. 

CDA knows that some dental plans that bid to offer coverage in the Exchange were not selected, but the names of those plans have not been released. 

Open enrollment is set to begin on Oct. 1, for coverage beginning Jan. 1, 2014.  

Peter Lee, the Exchange’s executive director, took the opportunity of the release of the information about the selection of the dental plans to announce that it is their policy that no one will be required to purchase the pediatric dental benefit in this first year of operation pursuant to federal guidelines. Lee stated that the Exchange would like to work with CDA and other stakeholders to see about mandating purchase of the pediatric dental benefit for 2015. 

CDA is continuing its advocacy to require all children who obtain coverage through the Exchange to include the pediatric dental Essential Health Benefit. In recent testimony before the Exchange Board regarding this issue, CDA reiterated its position that it is clearly the intent of the ACA to ensure that all 10 of the Essential Health Benefits are purchased for children. While the federal guidance presented earlier this year allows states flexibility on this issue, CDA contends that California should work to ensure the pediatric dental benefit is purchased for all children. CDA is in talks with the Exchange Board and staff, and a special Exchange Board meeting focusing on pediatric dental will be held in August. 

CDA will continue its advocacy on this issue and will keep members informed. 

For more information, please contact CDA’s Manager of Legislative Affairs Nicette Short at nicette.short@cda.org