Dental plans are often seen as a way to increase your sales in addition to offering major medical plans and voluntary benefits. Yet, in most cases, especially with the employer market, dental has been offered as an employee-paid add-on. With the advent of PPACA, dental is being stripped out as a separate product, and will be offered to employees for an extra premium separate from health insurance.

However, there still seems to be confusion about the applicability of the new PPACA amendments to dental and vision plans and when these plans may be exempt.  The new amendment requirements under PPACA (age 26 rule, preventive care, annual limits restrictions, etc.) apply to a "group health plan," which is an employee welfare benefit plan that provides medical care. PPACA uses the definitions that were already existing in the HIPAA portability rules, which define "medical care" very broadly. However, the HIPAA portability rules do contain an exception for "limited scope" dental and vision coverage.

HIPAA regulations say that a dental or vision plan will meet this exception if they are provided under a separate policy, certificate, or contract of insurance or are otherwise not an integral part of the plan. The regulations go on to say that benefits will be considered "not an integral part of the plan" only if: (1) participants have the right to elect not to receive coverage for the benefits, and (2) if a participant elects coverage, the participant must pay an additional premium or contribution for that coverage. If the dental and vision benefits are under separate insurance policies, they likely would fall under the exception. However, if they are self-funded (or insured, but not under a separate policy), the regulation requires that the participant must be able to separately elect to receive coverage, with corresponding difference in premiums or contributions.