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A subgroup of the National Association of Insurance Commissioners (NAIC) has been hosting twice weekly calls as they update the NAIC Network Adequacy Model to reflect with the ACA provisions and increased scrutiny of networks by the states. The subgroup consists of a variety of stakeholders, including regulators, carriers and consumers. This Model is critical to the insurance industry as it will become the new basis of network regulations for the states, as well as for carriers operating on the Federally Facilitated Marketplace (FFM).

To follow-up on a meeting held in September on this topic, NADP along with the Life Insurance Council of New York (LICONY) responded this week with industry views and recommendations on New York network adequacy standards. Recommendations include that agencies consider carriers attempts to recruit providers in shortage areas and allow for an exemption or alternative network adequacy requirements in upstate counties that lack “recruitable” providers. An additional meeting or conference call may be held after the agencies review and respond to industry recommendations.

MonthlyByte     December 2015   STI 2015 Highlights To enhance representation of the dental benefits industry, the NADP Board of Directors approved creation of the Standards and Transaction Initiative…

The Government Relations Workgroup (GRW) and its subgroup on Network Adequacy monitor legislative and regulatory proposals impacting the dental benefits industry.

NADP was contacted by the Congressional Budget Office (CBO) this month and met via conference call to discuss the equitable treatment bill, H.R. 3463.

To add value to your membership and the market intelligence you receive, the Research Commission has enhanced the Enrollment Survey to provide greater insight into in-force and new enrollment. This approach will provide NADP members with insight regarding sales data, which had previously been collected in joint reports with LIMRA.

Because helping members navigate the economic and public health impacts of the COVID-19 is a top priority, NADP launched a series of quick-scan surveys focused on dental plans’ response to this unprecedented global event. These quick scans are easy to complete and provide members’ colleagues insight into the dental benefits industry’s response to the COVID-19 pandemic. The surveys are launched every two weeks, and results, when appropriate, are published in the COVID-19 Open Forum and available to members only.

Data for NADP Benefit Utilization Survey is due the week of July 6 for plans with claims from California residents, August 1 for everyone else.

The survey focuses on non-DHMO insurance products only and includes Medicare Advantage dental benefits. This survey tracks the number of procedures per thousand members.

Does your company work with dental consultants? Looking for ways to improve that relationship? Building upon the conversation that began during the CONVERGE 2020 session, “Dental Consultants: Love Them, Hate Them, How to Work with Them,” the NADP Membership WorkGroup recently approved the Carrier/Consultant Member Interest Group (MIG) petition. The purpose of this MIG is to facilitate business relationships between dental carriers and consultants. The MIG has a dedicated Dental Interact community to enable their discussion

At the state level, NADP has closely monitored trends in Medicaid expansion, Medicaid coverage of adult dental benefits, and the creation of State-based Marketplaces (SBMs).