Pediatric Dental in 2021. . . Yup, We're Still Talking About it!

When the ACA was passed in 2010, my good friend Marty Marino said to me more than many times, 'There's a lot of opportunity in that bill Dom.' As much as I complain and carry on about the minor nussances and annoyances in our business, I am very grateful for the opportunities it has afforded us and Marty was right, the ACA was one big ol bundle of opportunity.


The biggest opportunity for BPI has been pediatric dental. When it first rolled out in 2012/2013 we spent a lot of time working with agents to find the solutions for their clients. You might remember Michigan was unique in that it allowed the medical carriers to offer 9.5 Essential Benefits of the ACA and allow the groups and agents the opportunity to select their own pediatric dental plans. This created an enormous opportunity in the small group dental market and because small groups who had never been in the market were now buyers and groups who hadn't shopped in quite some time were now shopping!


We were blessed enough to have Delta Dental of Michigan partner with us in the small market so we introduced them just at the right time. Delta, along with our other key partners all became 'certified' pediatric plans in Michigan and away we went.


Fast forwarding to 2021, much has remained the same. We still have pediatric only plans from Delta Dental. We can still sell them as stand alone or coupled with an adult plan. We can even sell a 'shell' plan with zero enrolled and we have done many of these.


In addition, our wonderful partners, Unum, Met/MMA, Guardian and Kansas City Life are all still 'certified EHB dental carriers' by the State of Michigan. One key change this year 2021 is Companion Life did not elect to become 'certified' but they still offer the benefits that mirror the pediatric benefit. Also Guardian is only certified in pockets and would let you know when those apply during quoting.


The biggest change you will experience depends on your book with Companion Life. You will notice with their renewals, they included a note that outlined the change in their dental and how this is no longer stamped 'certified' by the State of Michigan. And this has affected rates so you might see a swing. Your question is what to do with those groups.


The bottom line is this--you and the group still sign the group agreements with ACA carriers stating you will provide EHB dental. Level-funded carriers like Aetna do not require it because they are exempt from the 10 Essential Benefits. Per the letter of the law, that dental needs to be certified along side ACA plans. Now, there is no longer an individual mandate and to anyone's knowledge not one group or individual has been audited on whether pediatric dental exists in their plan. Still it is a law and it is a rule, one that has been followed to the tee by some, loosely by others and not at all by others.


As for us at BPI, we will work proactively with you to offer options for your Companion pediatric dental renewals. We have carriers that fit well! Our goal is to continue to serve you on these lines of business and offer the proper solution proactively. We may ask you for an updated census so we can quote options but the process should be quite painless for you as we go through it. Still, if you have questions on this, please give Dominic a call at 616.481.8675 and we can discuss further!



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