Members Track State EHB Decisions; Upcoming Project to Collect Plan Documents

July 2015

Members Track State EHB Decisions; Upcoming Project to Collect Plan Documents

NADP members and volunteers continue to track state decisions on new state essential health benefit (EHB) benchmarks for use beginning in 2017. The following are the most recent updates posted in Dental Interact (DI). It is likely CMS will post all 51 state decisions in a notice for public comment in August, which could then be finalized in the fall.

• Conneticut: The state-based Marketplace, Access Health CT, Board of Directors met on June 18 and considered options for the benchmark. According to the record of votes, the Board voted to adopt “Carrier A” benchmark plan, which is described in the presentation as one of the three largest small group market plans. A simple chart of benefits indicates pediatric dental is covered under this plan; therefore, supplementing the benchmark with either CHIP or FEDVIP may not be necessary. http://www.ct.gov/hix/lib/hix/PRESENTATION06182015.pdf (This is now reflected in the first sheet of the EHB Grid)

• New Mexico: NADP member volunteer reports that the NM Office of Superintendent of Insurance (OSI) submitted the CHIP as an EHB supplement for the dental benefits.

• New Hampshire: NADP member volunteer reports that the New Hampshire Insurance Department (NHID) expects to use FEDVIP again for its dental benchmark.

• New York: New York State formally submitted its selection of its Essential Health Benefits benchmark plan to Health and Human Services. New York has selected the benefits of the State’s largest small group plan, Oxford EPO, as the benchmark plan for 2017. According to the letter, there will be no need to supplement benefits. http://on.ny.gov/1OoNUYH

Of the 15 or so state decisions tracked in the EHB Grid, just over half will no longer need to supplement their benchmark with either FEDVIP or CHIP for dental as the medical benchmark includes such benefits.

Government Relations and Exchange Policy Workgroups plan to compile plan documents and track the dental services included in each of the benchmark plans. Because the medical plans with embedded dental being chosen now for 2017 would have been based on the 2014 dental supplement, it’s unlikely there will be changes in the benchmark related to dental; however, carriers and NADP volunteers will want to review the benefits in case the medical plan was able to offer any new or different services compared to the 2014 benchmark.  

If you have additional state updates or benchmark plan documents, please send them to Eme Augustini or post them in Dental Interact (DI).