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Pediatric News--BPI Carrier Plans for 2015

It has been quite a journey the past year since pediatric dental reared its ugly head here in Michigan.

All in all, most carriers now have settled in and figured out a way to offer a plan for their agents and groups. We were lucky here at BPI in 2014 because Metlife and Delta Dental were national leaders in the pediatric dental arena. Companion Life and Kansas City Life had to play catch up but they have found their stride for 2015.

Here's how they all stack up. Notice the true out-of-pocket maximums for all the pediatric options have lowered to $350 per child and $700 per family in 2015.

1. Companion Life

Companion is ACA Certified for 2015. We can quote all new business with the pediatric benefit. Here is a sample quote. You'll see on this document that the pediatric is not a 'better of' benefit rather the children have a set pediatric benefit that will be different in some instances than the adults.

On your inforce business, Companion will not be automatically adding the pediatric benefit. You would ask us to quote that through the home office. There is a slight increase to add the pediatric benefit and it affects the family rate most. If a group would like to move forward, there is a process that involves writing an entire new plan with a new group number. The reason for this is Companion has to set its claims process in a way that it knows how to pay two sets of benefits in one.

Companion Life also offers an Adult Plus Wrap plan that will 'wrap' around a stand alone pediatric plan like the Blues or Delta. You can read more about this plan in the article lower on this blog.

2. Kansas City Life

KCL is quoting pediatric dental on new business and theirs is a 'better of' plan. In force groups will not automatically add the pediatric dental. We have to request a quote on your behalf. If the group would like to add the pediatric benefit, it will enter into a new contract exactly like the Companion above.

3. Metlife and the MMA

We have the ability to quote Met and the MMA with and without EHB plans. Current business with Met and the MMA that have been on the books since before 1/1/2014 already have the EHB added. Their version is a 'better of' plan and it includes medically necessary orthodontia.

4. Delta Dental

We have the ability to quote Delta with or without EHB. Here is a sample of Delta's 2-9 enrolled plans with EHB for 2015. Delta's plans are not 'better of' plans and they do not include medically necessary ortho. Current business with Delta has to add the pediatric piece.

We do quite a few pediatric only plans with Delta. The new rates are outlined here for Priority Health groups and non-Priority groups respectively.


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