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LEGAL PROCE
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PUBLICATION & REG
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BRANCH ONS

As of: Septempet 09, beard
Received: August 16, 201

PUBLIC Se aos, zo0

SUBMISSION Comments Due: August 16, 2010

Submission Type: Web

Docket: IRS-2010-0010
Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered
Health Plan Under the Patient Protection and Afforable Care Act

Comment On: IRS-2010-0010-0001
Group Health Plans and Health Insurance Coverage: Interim Final Rules for Relating to Status as
a Grandfathered Health Plan under the Patient Protection and Affordable Care Act

Document: IRS-2010-0010-0918
Comment on FR Doc # 2010-14488

Submitter Information

Name: Kim Volk
Address:
1515 W 22nd St
Ste 450
Oak Brook, IL,
Organization: Delta Dental Plans Association

General Comment

See attached file(s)

Attachments

IRS-2010-0010-0918.1: Comment on FR Doc # 2010-14488

https://fdms.erulemaking.net/fdms-web-agency/component/submitterInfoCoverPage?Call=P... 9/9/2010


August 16, 2010

www.deltadental.com

Office of Health Plan Standards and Compliance Assistance
Employee Benefits Security Administration

Room N-5653

U.S. Department of Labor

200 Constitution Avenue, NW

Washington, DC 20210

Attention: RIN 1210-AB42

Office of Consumer Information and Insurance Oversight
U.S. Department of Health and Human Services
Attention: OCIIO-9991-IFC

Mail Stop C4-26-05

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Baltimore, Maryland 21244-1850

CC::PA:LPD:PR (REG-118412-10)
Internal Revenue Service

1111 Constitution Avenue, NW
Washington, DC 20224

Re: Comments on Interim Final Rules for Grandfathered Health Plans Under the PPACA
To Whom It May Concern:

I am writing on behalf of the Delta Dental Plans Association (DDPA) in response to the
invitation for comments included in the “Interim Final Rule for Group Health Plans and Health
Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient
Protection and Affordable Care Act.” See 75 Fed. Reg. 34537 (June 17, 2010). Our member
companies are providers of stand-alone dental benefit programs that are “excepted benefits”;
group health plans separately contract with our members to provide dental-only coverage to
employees.

DDPA is providing comments with respect to that portion of the Interim Final Rule regarding
subsection (g)(1) that establishes rules for changes causing cessation of grandfather status.
Because stand-alone dental benefit plans are “excepted benefits” and are not subject to the
insurance market reforms of the PPACA, we believe that it is important for the final rules to
clearly state that the requirements of subsection (g) do not apply to such stand-alone dental
benefit plans in connection with a group health plan.

Specifically, guidance is needed when a “grandfathered” group health plan or group health
insurance coverage has provided “bundled” benefits that combine medical and dental benefits as

Delta Dental Plans Association Telephone 630-574-6001
1515 West 22" Street, Suite 450 Facsimile 630-574-6999
Oak Brook, Illinois 60523


one benefit package. If a “grandfathered” plan chooses to continue the dental benefits but as a
separate, unbundled dental benefit, that stand-alone dental-only benefit plan would be considered
an “excepted benefit” plan. This type of benefit design change does not have the adverse
consequences of substantially altering the benefits provided to covered persons. Accordingly,
this benefit design change should not impact the grandfathered status of the medical health plan.

Likewise, in cases where a “grandfathered” group health plan or group health insurance coverage
changes dental benefit providers of stand-alone dental coverage without substantially altering the
level of benefits, the regulation should be clarified to state this should not be viewed as a change
that by itself would cause the plan or insurance coverage to lose “grandfathered” status.

At this point, group health plans are wary of any change to their benefits which may jeopardize
“grandfathered” status, The above comments will clarify the result of making changes to the
dental benefit, which typically is a stand-alone “excepted benefit” and therefore should not
impact a group health plan’s grandfather status. Absent this clarity, insurers who currently
provide bundled benefits to group health plans are being given an unfair competitive advantage
in the marketplace. This uncertainty also may result in a group health plan retaining a dental
benefit package which is not the most advantageous for consumers and/or is not the most cost
efficient dental benefit package. Clearly, these consequences were not, and in fact are
contradictory to, the intent of health care reform. The above clarifications will enable group
health plans to provide the most cost effective and/or highest level of dental benefits to their
members.

We very much appreciate the opportunity to provide these comments on this important interim
final regulation. Please feel free to call me or my staff if you have any questions or comments.

Sincerely,

£ Yee.

im Volk
President and CEO

About Delta Dental

Delta Dental is the nation’s largest, most experienced dental benefits company. Since 1954,
Delta Dental has worked to improve oral health in the U.S. by emphasizing preventive care, and
making quality, cost-effective dental benefits affordable to a wide variety of large and small
employers and groups. A nationwide system of dental health service plans, Delta Dental offers
custom programs and reporting systems that provide employees with quality, cost-effective
dental benefit programs and services. Our nationwide network serves more than 54 million
Americans in over 93,000 group plans across the nation.