Stand-alone dental plan—description of ehb allocation please fill in the following information. hios issuer id: applicable hios plan ids (standard component): certification language: for the plans listed above, the portion of the monthly premium allocable to the pediatric dental essential health benefit of a child-only plan, is. That is specific to dental carriers (i.e. stand alone dental plans – actuarial value supporting documentation and justifications” and “stand-alone dental plans – description of ehb allocation)”.. Dental form and rate filing requirements - stand-alone dental plans and other dental insurance plans. insurers wishing to offer in wisconsin a marketplace-certified stand-alone dental plan (sadp) that meets the standards related to the pediatric dental essential health benefits must comply with all wisconsin policy form and rate filing requirements..
Stand‐alone dental plans—description of ehb allocation √ note: the company may strike through any items that are not applicable. third party authorization (bypass if n/a) √ stand‐alone dental plan actuarial value supporting documentation and justification √ high level summary document. Supporting documentation and justifications” and “stand-alone dental plans – description of ehb allocation)”. 4. please indicate the form and page number where the benefit is described in the page# and document column if applicable.. Required for all stand-alone dental plan issuers . submission . stand-alone dental plan—description of ehb allocation . detailed description of the methods and specific analysis used to determine the ehb apportionment for pediatric dental. required for all stand-alone dental.
