CMS released its 2024 Notice of Benefit and Payment Parameters Final Rule, which includes three key updates for stand-alone dental plans.
Three things to know, according to an April 17 news release from CMS:
1. All individual market qualified health plans, including stand-alone dental plans, must use a network of providers that complies with the network adequacy and essential community providers standards in those sections. CMS is removing the exception that these sections do not apply to plans that do not use a provider network.
However, there are some exceptions for stand-alone dental plan issuers that sell plans in areas where it is deemed "prohibitively difficult" for the issuer to establish a network of dental providers.
2. Stand-alone dental plan issuers will be required to use age on effective date as the only method to calculate an enrollee's age for rating and eligibility purposes starting with Marketplace certification for payment year 2024.
3. Stand-alone dental plan issuers will be required to submit guaranteed rates starting with Marketplace certification for payment year 2024. This rule applies to Marketplace-certified stand-alone dental plans.