Navigating Benefits

Understanding Health Care Reform and Its Impact on Dental Benefits

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Posted by November 28, 2016

Are you having trouble navigating health care reform within your small (or medium-sized) business? You’re definitely not alone. The Affordable Care Act (ACA) is one of the more significant laws to pass in U.S. history and has revamped the landscape for benefits, including some important changes for dental offerings. What makes the law even trickier is that it’s being introduced in stages, so every year you need to adjust to new regulations for you and your company.

2016 Recap

It was a year of big changes for medium-sized employers, which is a company with between 51 and 100 full-time equivalent employees. If that’s where your business fits in, 2016 was the first year you’re required to offer health-insurance coverage to your employees or you will need to pay the ACA tax penalty as the National Conference of State Legislatures lays out, which adds to your insurance costs.

Large employers with more than 100 employees and small employers with fewer than 50 full-time employees shouldn’t face many changes going forward because they’ve already gone through their major health care rollouts. In 2014, small employers needed to change their health insurance plans to meet the new ACA coverage requirements. In 2015, large employers with more than 100 employees were required to start offering health-insurance coverage. After 2016, no major changes are planned for employers but, of course, the government could always pass new laws. With that, make sure to review your benefits every year and share necessary changes with your employees.

Also, some states are also changing their rules so that companies with 51 to 100 full-time or equivalent employees need to offer small-employer health-insurance plans. Small employers have less leeway in designing their health-insurance plans compared to large employers. This will be important for dental benefits.

How Dental Benefits Are Affected

All small-employer health-insurance plans now need to offer the 10 minimum essential benefits and this includes pediatric dental care for children younger than 19. If you run a small business and want to offer health insurance, your health-care plan now needs to include pediatric dental benefits, which could increase your cost.

Health care reform didn’t change dental benefits for large employers. If your company has more than 100 employees, you don’t need to change your dental plan or add any new dental benefits.

The companies which really need to be careful are medium-sized employers. If that’s you, check if your state expanded its definition of small-business plans to include your company. If so, your health-insurance plan needs to start covering pediatric dental benefits. Otherwise, your plan doesn’t meet the ACA coverage requirements and you could face costly penalties. You can find a penalty breakdown here.

Changes to Come

Going forward, health care reform shouldn’t have a large impact on employer dental benefits. There are no new requirements for covering adults so your company can keep the same plan for employees or continue not offering adult coverage. Since the ACA does not change requirements for adult plans, pricing trends shouldn’t change.

However, if your health-insurance plan needs to offer the 10 essential benefits, ensure your plan offers the necessary pediatric benefits. Contact your health-insurance company and ask to go over these requirements. This is really important if you’re a medium-sized employer because you could be facing several rapid, new rules this year.

Employers still need to adapt to health care reform but you will start to see the end of the tunnel soon. These are the last major rollouts that will affect your health care and dental-benefits plan, at least until (or if) a new plan comes into action. Start the year off right and catch your company up on all necessary changes.

How is your company handling these adjustments? Tell us about your experience on Twitter.

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