Question: I’ve gotten conflicting answers about this (pediatric dental). Covered CA rep said they were required to offer it but I was not required to buy it. But Anthem won’t let me buy a policy through them without the added PD policy (its not included in the medical policy). Anthem rep says its the state law & that possibly Covered CA has an exemption even though they are offering identical policies. The State Dept of Insurance could not explain why the difference in answers. What gives!?
Answer: Months ago, Covered California decided not to require carriers seeking to participate in the exchange to include pediatric (-19) dental benefits in their medical plans offered through the exchange. So the carriers set their rates without accounting for pediatric dental benefits. Later, the exchange realized they made a mistake and are actually out of compliance with, at least, the ACA’s intent on this issue. Too late, the rates were set. In the meantime, the carriers’ off-exchange plan offerings learn must include pediatric dental. What a paradox, the exchange is not including pediatric dental and out-of-compliance with the law and the non-exchange got it right.