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Smiling all the way to the bank

Group dental differs somewhat from individual dental plans, and both markets are definitely going to heat up as PPACA gets implemented over time.

By Mark Roberts | Updated on May 17, 2011

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.

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