June 7, 2013 Legislative Update Affordable Care Act Question of the Week: Essential Health Benefits The “Question of the Week” provides answers to frequently asked questions regarding the Affordable Care Act (ACA). If you have a general question about an ACA provision, contact your account representative. Insured small group plans that are non-grandfathered and individual policies that are non-grandfathered must cover Essential Health Benefits (EHBs) beginning in 2014. While large, self-funded and grandfathered plans are not required to offer EHBs in 2014, if they offer these benefits, they must meet certain cost-sharing requirements. Q. Will adult dental insurance be required as an essential health benefit in 2014? A. There are no ACA provisions that would require coverage of dental services for adults. The law only requires pediatric dental coverage as an EHB for non-grandfathered fully insured small group and non-grandfathered individual plans with plan/policy years beginning on or after Jan. 1, 2014. |