NADP members
and staff continue to track essential health benefits (EHB) benchmark
updates from the states in Dental Interact (DI). Many states were
granted a deadline extension from CMS to July 1 to submit the EHB
benchmarks. As more states publish their decisions, NADP and the
Government Relations and Exchange Workgroups will track the decisions,
compare to prior benchmarks and publish analysis as available.

The following are some of the latest updates:

  • California (6/15): Senate Bill 43
    on essential health benefits has passed the Senate and been referred to
    the Assembly Committee on Health. The bill text includes existing law
    that the benchmark pediatric dental benefits are those offered to
    subscribers of the Healthy Families Program or CHIP. This is confirmed
    by reports
    from the National Health Law Program (NHeLP) that California intends to
    supplement with the dental benefits available to children under the
    CHIP program. The advocacy group is working to raise the age limit for
    pediatric services to 21.
  • Florida (2/3): A February meeting agenda
    for the Florida Health Insurance Advisory Board (FHIAB) indicates a
    possible proposal and vote regarding the EHB benchmark. Meeting minutes
    have not yet been posted.
  • Maryland (6/17): The Insurance Commissioner announced
    the state has selected CareFirst BlueChoice’s HMO HRA/HSA $1,500 plan
    to be the 2017 Benchmark Plan. All options considered include coverage
    for pediatric dental services. A background report is available online:
  • Massachusetts (5/15): The DOI released information about benchmark options, which were scheduled for discussion on May 15.
  • Minnesota (6/18):
    A volunteer reports that MN will likely default to the FEDVIP plan for a
    dental supplement. They don’t have any options that give them any
    significant difference in benefits (they wanted to add autism and some
    others but that was not one of the plans options). Therefore, it is
    unlikely there will be any stakeholder or public comment process. As the
    MN special session is over, the legislature is unlikely to act.
  • New Mexico
    (6/1): NM Office of Superintendent of Insurance (OSI) has asked for and
    received an extension to submit an EHB benchmark until July 1, 2015.
    The OSI also accepted comments on the options, which were published
  • Pennsylvania (6/12):
    The PA DOI accepted comments through June 12 on the selection of the
    benchmark. PA was granted an extension to submit the EHB benchmark to
    CMS by 7/1/15. At least two medical benchmarks include coverage for
    pediatric dental services with some orthodontia:
  • Vermont (6/3): A volunteer reports VT has selected the state CHIP plan as the dental benchmark.
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