Myth Vs. Fact
Health care reform and the Affordable Care Act (ACA) will change the face of medical coverage for many Americans over the next several years. But did you know there’s no reason to make any changes to your dental or vision plans? The Standard has you covered.
As a benefits decision maker, you’re following the ACA updates. But the sea of details can be overwhelming. We want to make sure you have the facts about dental and vision coverage in relation to the ACA so you can maintain the coverage you and your employees need.
Myths And Misconceptions About Health Care Reform
Myth: Employers must purchase dental benefits through a health insurance exchange.
Fact: Employers are not required to purchase dental benefits through an exchange.
Myth: Employers are required to purchase adult and child dental and vision benefits.
Fact: Employers do not have to purchase any dental or vision benefits in or out of an exchange.
Myth: Anyone purchasing medical coverage through an exchange must purchase pediatric dental and vision benefits.
Fact: Employers and individual consumers are not required to purchase any pediatric or adult dental benefits in an exchange. Depending on the state, employers and individual consumers may purchase pediatric dental benefits from stand-alone dental carriers or packaged with medical coverage in or out of an exchange. Pediatric vision coverage will be embedded in the medical plan.
Myth: Purchasing a medical plan that includes dental benefi ts is cheaper than purchasing separate medical and dental plans.
Fact: Combining medical and dental benefits in one insurance policy could mean a large combined deductible. In that case, children’s nonpreventive dental expenses are not covered until the medical deductible is satisfied.
Today, about 98 percent of Americans with dental coverage have a dental benefit policy separate from their medical policy.* Most medical plans with pediatric dental and vision benefits do not include adult coverage.
Myth: Employers with fewer than 25 eligible employees may receive tax credits when they provide dental coverage.
Fact: Employers do not have to purchase dental coverage to get tax credits. Employer tax credits are based on medical coverage and are only available when purchasing in an exchange, and only in 2014 and 2015.
Myth: Employees who are at or under 400 percent of the federal poverty level** will receive a healthcare subsidy (premium tax credit).
Fact: Employees of small employers (50 or fewer employees) who purchase benefits in the SHOP exchange will not receive premium tax credits.
Only individuals who purchase benefits in the public individual exchange can obtain premium tax credits to help with medical premiums.
* National Association of Dental Plans, “Offering Dental Benefits in Health Exchanges: A Roadmap for Federal and State Policymakers,” September 2011.
**Poverty levels are defi ned by the federal government, and then determined by each state.
Keep things simple – stay with The Standard for your dental and vision coverage. Talk with your benefi ts advisor about the best option for your medical benefits.
The Standard is a marketing name for StanCorp Financial Group, Inc. and subsidiaries. Insurance products are offered by Standard Insurance Company of Portland, Ore. in all states except New York, where insurance products are offered by The Standard Life Insurance Company of New York of White Plains, N.Y.
Product features and availability vary by state and company, and are solely the responsibility of each subsidiary. Each company is solely responsible for its own financial condition. Standard Insurance Company is licensed to solicit insurance business in all states except New York. The Standard Life Insurance Company of New York is licensed to solicit insurance business in only the state of New York.