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Healthcare Reform - Dental Solutions

Story Content Provided by Assurant on 8/28/13

The pace at which guidance and clarifications related to the Patient Protection and Affordable Care Act (PPACA) are circulating, for some, might be a dizzying experience. Do this. Do that. Can I do this...or that? One thing is for sure - clarity and definition will only come as implementation of the Act continues. With so much uncertainty, you are likely proceeding with caution as you evaluate the needs of your customers and the varying options available to meet their needs.

Assurant Employee Benefits' focus is on providing a dental solution small employers need and want...not what we want. We'll leave medical to the medical carriers - they are the experts there. We can however, help keep you in front of the options related to the pediatric dental Essential Health Benefit (EHB) requirement.

Let the dust settle. The reality is that no one knows how the law will look fully implemented 12, or even 24 months from now - there is much yet to be determined and uncertainty leads to the risk of making the wrong decision.

  • Large employers, generally more than 50 full-time employees for 2014 and 2015, will not need to make any changes to their dental or vision plans as a result of the PPACA.
  • Small employers will likely see the pediatric dental EHB services embedded in their medical plan...but those will generally be only dental services for the pediatric population (under age 19) and may not include some services such as non-medically necessary orthodontia. They will need a traditional dental plan for the employees, spouses and older dependents (generally 19 to 26), and for the traditional orthodontia.

Best Short-Term Bet: Look for a medical plan where the pediatric dental EHB services are included - that is, by the way, where every other EHB service is required to be. Keep a traditional dental plan in place for the employees, spouses, older dependents...AND for under 19 dependents so they will have access to traditional benefits, including orthodontia services.

If an employer is concerned about the cost of providing some pediatric dental services in both a traditional dental plan and their medical, look for a plan that offers a pediatric dental carve-out.

  • For January 1, 2014 effective dates, Assurant Employee Benefits will offer a new Assurant Dental option. When needed, an employer can exclude coverage for those dependents under age 19 that are covered for the pediatric dental EHB services under the EHB compliant medical plan. State variations will apply.
  • Later in 2014, we will expand our Assurant Dental capabilities to include the option of adding pediatric dental EHB services into a traditional dental plan - for those customers where it meets their needs.

Bringing Clarity to Complexity. The PPACA is complex and may seem overwhelming to understand at times - it is after all over 2,000 pages long, not including the many clarifications and changes. The good news is that the dental decision for employers does not have to be a difficult or complicated one. Assurant Employee Benefits can help you bring clarity to complexity - simplifying the dental decision and assuring your customers maintain the type of benefits they want.

You want the facts. We're here to help. Call to discuss the dental insurance needs of your customers - we'll help you make them smile.

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