Dental FAQs
When can Qualified Dental Plans be filed?
The federal data collection templates will not accommodate standalone dental plans until approximately May 20th, 2013. Because of this delay, some states with a state-based exchange may decide to create their own files for dental data collection. Qualified Dental Plan (QDP) submissions made using state specific data collection means standalone dental plans may be made in accordance with the state's deadlines. In all states using the federal data collection templates, QDPs cannot be submitted prior to the release of the finalized template. Issuers should check the state's Plan Management General Instructions for specific details on how to file dental plans in the state.
How does the federal data collection template work with Standalone Dental Plans?
If the issuer is filing to an SPE (State Partnership Exchange) or FFE (Federally Facilitated Exchange) state, the federal data collection templates must be completed. For ease of use, the Plan and Benefits template will be modified to accommodate standalone dental data. There is a selection button at the top of the Plan and Benefits template for "Dental". Once selected, a macro will modify the template to gray out columns and rows that are not applicable when filing dental plans. Because medical and dental plans use the same template, and only one Plan and Benefits template can be added to a Binder, the issuer must create separate Binders for medical and dental plans.
How should Embedded Dental Plans be submitted?
Embedded dental plans have been described as those dental plans for which the medical plan issuer is the ultimate responsible party assuming the risks and liability associated with the dental benefits even if the benefits are administered and provided under a 3rd party contract. These plans may have previously been filed as a rider on a medical plan. If filed using the federal data collection templates, embedded dental benefits can be included with the medical benefits for the plan, using the same Standard Component ID. Please refer to the state's Plan Management General Instructions before filing dental plans.
How should Bundled Dental Plans be submitted?
Bundled plans would also have their dental benefits administered and provided under a 3rd party contract, but in this case the third party administrator assumes the risks and liability associated with offering the dental benefit. When filing to any state using the federal data collection templates, these types of plans will need to be filed separately, with each party being responsible to submit the benefits for which they bear the risk. Please refer to the state's Plan Management General Instructions before filing dental plans.
Didn't find what you needed here?
The SERFF Help Desk is a great source of information.
Contact the SERFF Help Desk by calling 816-783-8500 or emailing serffhelp@naic.org.