Health Care Reform

Health Insurance Exchanges

Starting January 1, 2014, state-based, federally-facilitated or state-federal partnership Health Insurance Exchanges will become operational. There are two Exchanges, individual and small group, that are described in the Affordable Care Act (ACA), and a state has the option of combining them into one. Exchanges will allow small businesses and individuals to buy required essential health benefits. Health benefits come in different levels (Bronze, Silver, Gold, Premium and Catastrophic). The Department of Health and Human Services (HHS) issued a proposed rule in November 2012 that allows states to select benchmark plans to determine what health benefits need to be offered inside Exchanges. People don't have to use public Exchanges to buy their coverage, but individual exchanges are the only place where government subsidies will become available to help people who meet certain income requirements.

We know that stand-alone dental benefits and children's dental coverage will be offered on Exchanges. We know that adult and family coverage will be offered on some exchanges. But there are still some details that are unclear. The final exchange rule stipulated that dental benefits can be offered and priced separately from medical benefits if it is in the best interest of the consumer. In today's commercial market, dental and medical benefits are sold as separate policies 97 percent of the time, so it is our hope that the same structure will remain within Exchanges to allow consumers to have a transparent shopping experience.