As of January 1, 2014 of last year, most Americans will be required to have dental coverage for their children. The Department of Health and Human Services (HHS) is charged with defining what the benefit plans look like and what the age limit will be. In a November 2012 Notice of Proposed Rulemaking on the essential health benefits (EHB), HHS proposed an age limit of up to 19, with the option for states to raise it higher. In the same EHB proposed rule, HHS sets up a framework that would allow states to select “benchmark” health plans that would serve as standards for coverage on Health Insurance Exchanges.

According to this guidance, if a state does not select a health plan with pediatric dental coverage in it, it can select either the Federal Employee Dental and Vision Plan (FEDVIP) or the Children’s Health Insurance Plan (CHIP) plan as a standard for the state. If the state opts not to make a selection, the pediatric plan for the state will default to FEDVIP. These selections would be revisited by HHS in two years.