NADP, DDPA Give States Important New Tool to Help Design Insurance Exchanges

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Industry White Paper Outlines Common-Sense Recommendations for Offering Dental Policies in Exchanges

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"... it’s important for states to address dental benefits as they craft exchange rules and shopping systems, otherwise people could end up with fewer choices, not more, or they may be forced to find a new dentist."

Policymakers and work groups charged with creating state insurance exchanges have been given a new tool to help them increase access to dental benefits. The National Association of Dental Plans (NADP) and the Delta Dental Plans Association (DDPA) have issued a white paper entitled, “Offering Dental Benefits in Health Exchanges: A Roadmap for Federal and State Policymakers,” aimed at helping policymakers navigate issues unique to dental benefits.

“While there is disagreement about many of the details of health care reform, creating places where consumers can comparison shop for their health insurance is one idea with bipartisan support,” said Kim Volk, president and CEO of DDPA. “It makes sense that as policymakers work to establish exchanges, medical coverage has been the primary focus,” said Volk. “But, it’s important for states to address dental benefits as they craft exchange rules and shopping systems, otherwise people could end up with fewer choices, not more, or they may be forced to find a new dentist.”

The Affordable Care Act (ACA) includes ‘pediatric oral services’ as part of the federally mandated Essential Health Benefits Program (EHBP) to be offered in the small group and individual markets both inside and outside exchanges. The law also ensures that consumers will be able to shop for their children’s dental benefits from stand-alone dental benefits providers. “The vast majority of people with dental coverage today purchase those benefits separately from their medical benefits,” said Evelyn Ireland, NADP’s executive director. “The ACA allows consumers purchasing through Exchanges the option of purchasing separate dental coverage. It’s important that state exchanges plan for the offer of dental benefits from the outset, otherwise consumer choice will be limited and the very objective exchange planners sought to achieve will be thwarted,” said Ireland.

The timely paper examines issues relevant to the offering of separate dental policies by exchanges and highlights the fact that millions of individual and small-group consumers now have, and will maintain, dental coverage outside of the exchanges. Therefore, it will be critical for policymakers to follow the path outlined in the white paper and properly define state exchange processes to allow these consumers to keep their dental coverage and the dentists they now use for themselves and their children.

In addition, the white paper recommends processes for exchanges 1) to verify and accept current dental coverage and 2) to offer dental coverage to those consumers that don’t have it today. It provides background on the current dental marketplace and offers common-sense solutions for state and federal policymakers engaged in exchange design.

The white paper is available free of charge at or

About Delta Dental Plans Association
The not-for-profit Delta Dental Plans Association ( represents 39 independent Delta Dental member companies operating in all 50 states, the District of Columbia and Puerto Rico. As the nation’s largest dental benefits provider, Delta Dental serves more than 56 million Americans in more than 95,000 employee groups. In 2010, Delta Dental member companies donated more than $48 million throughout the country to support programs that focus on preventing dental disease, expanding access to care, advancing dental science and understanding the connections between oral and overall health.

National Association of Dental Plans (NADP), a Texas nonprofit corporation with headquarters in Dallas, Texas, is the “representative and recognized resource of the dental benefits industry.” NADP is the only national trade organization that includes the full spectrum of dental benefits companies operating in the United States. NADP’s members provide Dental HMO, Dental PPO, Dental Indemnity and Discount Dental products to 143 million Americans, approximately 90% of all Americans with dental benefits.


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