News

In the latest
round of Essential Health Benefits (EHB) news, the Washington Office of
the Insurance Commissioner (OIC) published a proposed rule
outlining the state’s benchmark selection and dental supplement. i.e.
Children’s Health Insurance Program (CHIP). The proposed rule reverses
the approach to dental from a previous exposure draft, which designated the dental benefits that were included in the medical benchmark Regence Direct Gold plan.

With the
addition of Washington, NADP tracking shows 8 states have selected CHIP
as the supplement for pediatric dental services for Plan Year 2017. Two
have chosen the FEDVIP plan, and at least 6 states have selected dental
benefits that are embedded in the medical benchmark.

It’s
anticipated the Center for Consumer Information and Insurance Oversight
(CCIIO) will publish a full list of state selections (or defaults if a
state did not actively select a benchmark) sometime this fall for public
comment.

Resources

An updated copy of the Essential Health Benefits Grid is available on the Advocacy Resources webpage.
A worksheet at the front of the workbook summarizes final EHB decisions
and indicates whether the dental benefits benchmark is changing from
2012 (for PY 2014) to 2015 (for PY 2017). A new worksheet (tab 3)
compiles services covered in the dental benchmarks based on CHIP, FEDVIP
and medical plan benchmark documents.

Please continue to forward state EHB decisions and plan documents to Eme Augustini so we can continue to build this resource.

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