At the Chicago Dental Society, we've heard that the Illinois State Dental Society receives several phone calls a day from members with questions about the Affordable Care Act (ACA), also referred to as Obamacare. The following bullet points address some of the questions currently being asked:
- Anyone seeking healthcare coverage to begin January 1, 2014, must have completed an application, chosen a plan and transmitted it to the selected insurer by December 23, 2013. Plans may be purchased on the Marketplace at healthcare.gov, by fax or by phone. Plans may also be purchased outside the Marketplace by use of an outside broker or directly with an insurance carrier.
- If you have been previously contacted by your major medical insurance carrier that your plan has been cancelled for 2014, the Illinois Department of Insurance (DOI) recently was given the option to extend those cancelled plans for one year by the federal government. The DOI has extended that option to the insurance carriers, leaving the carriers to decide.
- Pediatric dental benefits are a mandated offer but optional purchase on the Marketplace, but are a mandated offer and mandated purchase outside of the Marketplace. Pediatric dental plans will not have an annual or lifetime benefit maximum for covered services. There will be an out-of-pocket limit of $700 per child and $1,400 per family. As a dental provider, you will most likely not know the difference between dental plans purchased on the Marketplace versus outside the Marketplace. Adult dental benefits are not covered in the ACA.
- Small businesses with less than 50 employees are NOT mandated to provide major medical coverage to their employees; however, all employers have to furnish each of their employees with a notice that informs the employees that there are new health insurance marketplace coverage options available. Department of Labor notices designed for this purpose are available for printing and was distributed to the membership via email in September.
If you have additional questions, contact Dionne Haney, ISDS Director of Professional Services, at firstname.lastname@example.org or 800.475.4737.