Washington state has approved a proposal to allow dental insurers to offer standalone plans outside the state's health exchange for children's dental care in 2015.
Currently, medical and dental plans must be offered in one policy, according to a bizjournals.com story.
When this proposal takes effect, it will clarify the Patient Protection and Affordable Care Act (ACA) requirement that plans sold through health exchanges must include 10 essential health benefits, including pediatric dental coverage.
But this inclusion is problematic for dental insurers such as Delta Dental. Company officials note that some plans outside the exchange with embedded dental coverage have deductibles as high as $2,000. Delta Dental, which supports the concept of standalone plans, claims it's unfair competition because such health plans are charging for "an illusion of coverage."
Some groups opposed the standalone proposal. Medical insurer Premera said this coverage should only be offered as an embedded benefit outside the exchange, according to the story. The company noted that pediatric dental plans are subject to a premium tax but adult dental plans are not, and there is no guidance for insurers to split the tax. Adults who don't buy pediatric benefits will be required to pay the premium tax.
The rule is a response to a 2013 law allowing standalone dental plans for children.
