Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical...
Transcript of Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical...
![Page 1: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/1.jpg)
Ad Hoc Pediatric Dental Technical Work Group
January 15th, 2014
![Page 2: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/2.jpg)
Agenda
2
Ad Hoc Dental Technical Workgroup
Meeting and Webinar
Wednesday, January 15, 2013
1:30 p.m. – 4:30 p.m.
Covered California, Yosemite Conference Room
560 J Street, Suite 290, Sacramento, CA 95814
Agenda Items Suggested Time
I. Welcome and Agenda Review (Ellen Wu) 1:30-1:40 (10 min.)
II. Enrollment Process for Pediatric Dental (Kate Ross) 1:30-2:00 (20 min.)
III. Draft Proposal to Covered California Board for Pediatric Dental 2:00-3:00 (60 min.)
(Peter Lee joining by phone)
IV. Priorities for Ad Hoc Workgroup (Taylor Priestley) 3:00-3:45 (45 min.)
V. Wrap-up and Next Steps (Casey Morrigan) 4:00-4:15 (15 min.)
Send public comments to [email protected]
![Page 3: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/3.jpg)
ENROLLMENT PROCESS FOR
PEDIATRIC DENTAL - UPDATE
KATE ROSS, ANALYST
PLAN MANAGEMENT
2
![Page 4: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/4.jpg)
Ad Hoc Dental Technical Workgroup
4
• Enrollment Statewide
• Trend over time
• Go backs
• CalHEERs current status
![Page 5: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/5.jpg)
Ad Hoc Dental Technical Workgroup
5
![Page 6: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/6.jpg)
Ad Hoc Dental Technical Workgroup
6
![Page 7: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/7.jpg)
Ad Hoc Dental Technical Workgroup
7
![Page 8: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/8.jpg)
Ad Hoc Dental Technical Workgroup
8
![Page 9: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/9.jpg)
Ad Hoc Dental Technical Workgroup
9
![Page 10: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/10.jpg)
Ad Hoc Dental Technical Workgroup
10
![Page 11: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/11.jpg)
Ad Hoc Dental Technical Workgroup
11
![Page 12: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/12.jpg)
Ad Hoc Dental Technical Workgroup
12
![Page 13: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/13.jpg)
Ad Hoc Dental Technical Workgroup
13
![Page 14: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/14.jpg)
DRAFT PROPOSAL TO COVERED
CALIFORNIA BOARD FOR PEDIATRIC
DENTAL
2
![Page 15: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/15.jpg)
Proposed Policy Objectives
6
1. Maximize the availability of the advanced premium tax credit for
the pediatric dental benefit
2. Ensure the enrollment of all eligible children (<18) in the
pediatric dental benefit
3. Ensure the application of all consumer protections to the dental
benefit
4. Fairly spread the cost of the dental benefit across populations with
and without children
5. Equalize benefit design (coverage) on and off the Exchange
6. Structure cost sharing to ensure a meaningful dental benefit
(OOPM, deductibles)
Primary:
Additional:
![Page 16: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/16.jpg)
Recommendation:
Consistent with the Board’s directive, Covered
California recommends that the Exchange
offer an embedded pediatric dental benefit
side by side with a standalone benefit in plan
year 2015, understanding that the Exchange
must certify an otherwise qualified health plan
without a pediatric dental benefit (“9.5”) if
offered by an issuer in this context.
9
![Page 17: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/17.jpg)
Ad Hoc Dental Technical Workgroup
17
Tentative Additional Meetings
Wednesday, February 5
• Benefit plan designs
• Portfolio design (supplemental)
Wednesday, March 5
• Network issues (network adequacy, essential community
providers)
Wednesday, April 9
• Data submission and reporting
• Provider quality measures
![Page 18: Ad Hoc Pediatric Dental Technical Work Group - · PDF fileAgenda 2 Ad Hoc Dental Technical Workgroup Meeting and Webinar Wednesday, January 15, 2013 1:30 p.m. – 4:30 p.m. Covered](https://reader036.fdocuments.net/reader036/viewer/2022081521/5a9dca8c7f8b9ae0108b8fdf/html5/thumbnails/18.jpg)
Ad Hoc Dental Technical Workgroup
18
Wrap up and next steps