Health Care Exchange (Marketplace) Resource Center
Health Care Exchange (Marketplace) for Large Business
When it comes to the Health Care Exchange (Marketplace) and dental coverage, we’re experienced, knowledgeable and proactive. We’ll keep you on track with Affordable Care Act (ACA) information and dental plans that fit your needs to ensure a healthy workforce.
What you need to know
Under the ACA, dental plans provided by large employers (those with 51+ employees in most states) under a separate “risk contract” and/or provided under self-funded arrangements with a separate administrative arrangement from the medical plan (that render such plans “non-integral” to the medical policy) are considered “excepted” benefit coverage. With excepted benefit coverage, the dental plan provisions are not subject to ACA market reforms. In general, most large employers won’t need to make any changes to existing Delta Dental plans.
However, states may impose different regulations (within ACA guidelines) for excepted benefit coverage. For example, California requires that all dental plans for children extend coverage to age 26 (which matches the medical plan age requirement under the ACA). In most states, large employers may choose whether to include this provision in their dental plan to match it more closely to the ACA-required medical coverage provision.
Contact your broker, consultant or Delta Dental sales representative for more information about your state’s requirements and dental plan options under the ACA.