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Health Care Reform Overview

As of January 1, 2014, pediatric dental coverage (part of the Essential Health Benefits [EHB]) is mandated for individual and small group coverage. Pediatric dental EHB can be provided in one of two ways:

  • Included in the health plan or
  • Offered through a standalone dental plan.
The Right Dental Product for the Situation
Scenario Dental Solution

Pediatric dental embedded in health plan:

  • Behind the health deductible (skinny) – Health deductible must be satisfied before pediatric dental services will be covered. Low-cost solution that allows the employer to meet the EHB benchmark requirements while managing their health costs.
  • Preventive in front of the health deductible, Basic and Major behind the health deductible – Preventive pediatric dental benefits aren’t subject to the health deductible, but Basic and Major services are and won’t be covered until the health deductible is satisfied. This mid-cost solution allows the employer to meet the EHB benchmark requirements while managing their health costs. The offering helps encourage use of pediatric preventive services.
  • Preventive, Basic and Major in front of the health deductible (rich) – Dental deductibles are separate of the health plan. The member needs to satisfy only the dental deductible (if any) for dental benefits to be covered. This is a high cost solution.

Traditional Dental to insure no gap in coverage or large out-of-pocket cost for children.

Traditional Dental to minimize large out-of-pocket cost for basic and major services for children.

Dental that excludes coverage for children under age 19.

Pediatric dental – NOT embedded in health plan - Pediatric dental services will not be covered by the health plan. Dental coverage that includes pediatric EHB dental benefits

No matter where your client places pediatric EHB dental coverage, Principal Life has them covered with a choice of solutions that work together with their other benefits.


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