In 2018, CA passed SB 1008 which requires fully insured dental plans in CA to provide the same transparency standards as medical plans in the form of a “uniform benefits and disclosure matrix” dubbed as a dental SBC.
Background: The Affordable Care Act created a requirement that medical SBCs must be distributed to all eligible participants during open enrollment and at the time an employee is newly eligible. The intention behind this provision was to make it easier for benefit eligible employees to compare and contrast their medical options. Now, CA is requiring fully insured dental plans to distribute a dental SBC along the same terms with the same intention of making it easier to compare, contrast and better understand their dental coverage options.
Here’s what you need to know:
What is it? The dental SBC is intended to be a uniform benefits and coverage disclosure matrix much like the medical SBC created by ACA regulations.
What is the requirement? The CA law applies to fully insured dental plans that are written in CA. These plans must provide a dental SBC to eligible participants when the employee is newly eligible and during open enrollment.
Who will provide the dental SBC? The carrier will provide the employer with a dental SBC for all fully insured dental plans written in CA.
Employers must ensure they distribute the dental SBCs to their eligible employees during open enrollment and when an employee is newly eligible starting with plan years renewing on or after 1/1/2022.
Example: If the plan year begins on 1/1/2022, the dental SBC must be distributed to eligible participants during open enrollment for January 1. Thereafter, the dental SBC must be distributed to all newly eligible employees and during each open enrollment period.
Please contact your Bolton service team should you have any questions.