Covered California focuses on dental plan offerings for 2015

Wednesday, Feb 26, 2014



Even with the rollout of the Affordable Care Act (ACA) barely under way, Covered California, the agency charged with implementing the ACA in this state, devoted considerable time last month to planning for expanded dental benefit offerings for 2015. CDA has continued to push for making a variety of plan options available to all consumers, including adults, and the state is now moving in that direction, with many details still to be worked out.

Even with the anticipated changes, most dental offices should expect to see relatively little change to their patient base over the next year. So far, it does not appear that employers providing health and dental coverage to their employees are dropping or changing that coverage in significant numbers, and it will take time to see how many individuals and small businesses will obtain new dental coverage either through Covered California or from the private market (where standalone dental plans are being “bundled” with comprehensive health plans).

For 2014, Covered California is offering five standalone pediatric dental plans in both the individual and small business markets (Delta Dental, Liberty Dental, Anthem Blue Cross, Premier Access and Blue Shield), which can be purchased by enrollees for their eligible children. For this year, parents buying individual insurance are not required to purchase a pediatric dental benefit, but it is required to be made available to them. 

One change being considered by Covered California for 2015 has revolved around whether to require its full-service health plans to “embed” a pediatric dental benefit within its overall health coverage product. Covered California is also considering how and when it can begin offering supplemental adult dental benefits (which are not a mandatory Essential Health Benefit under the ACA) to their enrollees.

At its January meeting, the Covered California board voted to begin offering embedded pediatric dental benefits, alongside the standalone dental plans they are offering now, in January 2015. The board also decided to begin offering supplemental adult dental benefits no later than January 2016. In subsequent conversations, Covered California staff expressed a desire to begin offering “family plans” in January 2015 that would bundle pediatric and adult dental benefits into one product, which will hopefully give enrollees added incentives to enroll in a standalone dental plan.

Throughout this process, CDA in its advocacy efforts has consistently emphasized that while it fully supports improving access to dental benefits for children as well as adults, those benefits must be meaningful and enrollees must be able to clearly understand what they are purchasing. To that end, CDA continues to argue for consumers to have a choice of dental benefit offerings, and for the state to take steps to make sure that all participating dental plans maintain an adequate network of dental providers so that patients’ dental benefits do not turn out to be illusory. 

CDA remains actively engaged in all of the ACA implementation efforts, advocating on members’ behalf with the state Legislature, the administration, Covered California, other regulatory agencies and the federal government.  CDA is a resource to members interested in finding out more about the new law and how it may impact dentists and the patients they serve. 

For more information, contact Nicette Short, CDA manager of legislative affairs, at 916.554.4970 or nicette.short@cda.org.

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