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Saturday, August 10, 2013

Covered California delays offering 'embedded' dental plans

Board members of the California Health Benefit Exchange voted Thursday to delay soliciting bids for medical plans that include pediatric dental care until next year.

Covered California, the state's health insurance exchange, has said it will offer five stand-alone pediatric dental plans for 2014 as well as what's called a "bundled" plan in which insurers pair a stand-alone dental plan with a medical plan.

Critics have argued that Covered California should also offer so-called "embedded" pediatric dental plans that are included in medical plans.

But Leesa Tori, senior adviser for plan management, told the board at its special meeting that too many questions remain for the exchange to offer embedded pediatric dental plans before 2015.

The exchange still must decide whether to make purchasing dental insurance mandatory, and for whom it would be necessary. Until Covered California makes this decision, Tori said, staff members will not know which types of plans to include in the exchange.

"There is no silver bullet for 2014," said Tori, as board members considered final recommendations on pediatric dental plans. "What we are suggesting here is that we go back, we do the proper policy analysis, look at the various products and then put it into a portfolio for 2015."

Tori also said that six of the eight health insurance firms with the ability to provide embedded dental plans said they could not develop a bid for next year.

"If we thought we could, we would," said Susan Kennedy, one of the board members. "We don't believe it's technically feasible or in the best interests of consumers to do so right now."

The board's plan to solicit multiple options for children's dental plans in 2015 comes in response to concern from children's advocates and families about the affordability of pediatric dental care. Monthly premiums for the pediatric dental plans to be offered in 2014 start at $10 per child, depending on the plan. The plans cover children up to age 19.

A coalition of children's health advocates sent a letter on Monday to the health exchange's board members urging them to request bids for embedded pediatric dental plans in addition to the stand-alone and bundled plans the exchange has already solicited.

The coalition -- which includes Children Now, United Ways of California, California Coverage and Health Initiatives, The Children's Partnership and Children's Defense Fund California-- called for the board to give the public the opportunity to choose their dental coverage.
"Consumer choice is important, and we recognize that for some families the option to select a stand-alone plan will be attractive," the letter read. "But stand-alone plans must not be the only choice."

PHOTO: Tribal dentist Gurminderajit Sufi works on Jonathan Jesus Lomeli, 10, of Arbuckle at the Colusa Casino's Wellness Center on April 23, 2013. The clinic offers subsidized medical care for low-income families. The Sacramento Bee/ Randy Pench.

Read more here: http://blogs.sacbee.com/capitolalertlatest/2013/08/covered-california-delays-offering-embedded-pediatric-dental-plans.html#storylink=cpy

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