1. DENTAL TECHNICAL WORKGROUP
October 10, 2017

2. AGENDA I. Welcome and Introductions 11:00 - 11:10 (10 min)
Dental Technical Work Group
Meeting and Webinar
October 10, 2017
11:00 a.m. - 12:30 p.m.
Agenda Items Suggested Time
I. Welcome and Introductions : :10 (10 min)
II. Covered California’s Dental Web Page :10 – 11:30 (20 min)
III. Covered California Dental Standard Benefit Plan Design 11:30 – 12:00 (30 min)
IV. Program Improvements :00 – 12:20 (20 min)
V. Next Steps : :30 (10 min)
Send public comments to
Good morning, Thank you for joining us today for the Dental Technical Workgroup.
We are going to keep the phones unmuted for the call today.
Let’s go around the room for introductions. Then we will identify who is on the phone.

3. Covered California Dental WEB page

4. COVERED CALIFORNIA DENTAL WEB PAGE
Most frequently asked questions:
How do I enroll in a dental plan?
Can I enroll in a dental plan without a health plan?
Can you get dental insurance when it is not open enrollment?
How do I pay for my dental plan on the Covered California website?
How do I find dental providers that participate in my insurance plan?
I have received the questions asked by consumers regarding the dental program from the Marketing Division. I sent a link to the dental.com page with the agenda.
Most of the questions are about how to enroll in a dental plan.
These answers are included in the Covered California dental pages under “How to Enroll” but maybe, we could use more consumer friendly language. You can take a look at the page and get back to me with any sugguestions.

5. 2019 Dental Standard Benefit Plan Design

6. COVERED CALIFORNIA DENTAL PLAN DESIGN
2019 Dental Standard Benefit Plan Design Discussion Topics:
Adult Benefits
Adult Orthodontia
Adult Diagnostic and Prevention Plans
Covered California can sell only qualified health plans. Sand alone dental plans must include pediatric essential health benefits, but adult benefits can vary.
There has been interest in covering Adult Orthodontia and Adult Diagnostic and Prevention plan designs.
Tim from Dental Health Services will speak about offering Adult Orthodontia.
We have received input on offering Adult Diagnostic and Prevention Plans designs. These would be offered for Stand Alone Dental.
DPPO: recommend offering a low adult plan with diagnostic and prevention and basic benefits (no major benefits). This would represent a lower price option vs. high price plan. Work with an actuarial on rating would be required.
DHMO: recommend offering a low adult plan with diagnostic and prevention and basic benefits. In other states currently having adult low plans, Delta Dental covers major benefits; this would be an option to consider (higher copay makes it a "low plan"). This would represent a lower price option vs. high price plan. Work with an actuarial on rating would be required.

7. COVERED CALIFORNIA DENTAL PLAN DESIGN
2019 Dental Standard Benefit Plan Design Discussion Topics:
AV Calculations
Pediatric Dental 86.98% AV on coinsurance plans
Pediatric Dental 85.10% AV on copayment plans
The Pediatric Actuarial Value in the 2018 Standard Benefit Design is currently 86.98% on DPPO plans and 85.10% on DHMO plans.
Legal confirmed the State AV +/- 2 applies to pediatric dental benefits.
Market Stabilization Rule released:
Some of the input we received to lower the 2019 Pediatric Dental DPPO actuarial value.
class shift some of the benefits
raise deductibles or don't waive for diagnostic and preventive procedures
increase percent enrollee is responsible to cover

8. COVERED CALIFORNIA DENTAL PLAN DESIGN
2019 Dental Standard Benefit Plan Design Discussion Topics:
Independent Dental Plan Purchase
There has been interest in the ability to purchase a dental plan without purchasing a medical plan through the Exchange. We see an unmet need for purchasing a dental only product.
Currently SB 639 would prevent the purchase of stand alone dental plan with no purchase of a Covered California health plan due to the Federal out of pocket maximum limitations.
Our Family Dental Plans include a pediatric maximum out of pocket limit and currently there is no way of coordinating the out of pocket limit with off Exchange plans.
Jim has there been any update on this item?

9. Program improvements

10. PROGRAM IMPROVEMENTS Increase utilization Increase effectuation rates
Delta Dental has high utilization rates. Jim from Delta will speak to how Delta is achieving a high utilization rate.
Anthem Dental has high effectuation rates. Rick from Anthem Dental will speak about how Anthem achieves a high effectuation rate.

11. WRAP UP AND NEXT STEPS
Thank you for joining today. Your input was appreciated as always.
If anyone has topics they would like to discuss, please me.
So unless anyone has any questions, I think we're in good shape for now. Thanks, everyone.