NRECA Dental Plan Complies with ACA

The annual maximum benefit no longer applies to most pediatric dental services.

As a reminder, charges for pediatric dental services (including diagnostic/preventive services, certain restorations and extractions, but excluding orthodontia) for individuals under age 19 no longer count toward the annual maximum benefit as of January 1, 2014. Frequency limits, such as those for preventive care, and deductibles and coinsurances, still apply.

NRECA considers pediatric oral care to be an essential health benefit under the Affordable Care Act (ACA). Group health plans may not place annual dollar limits on essential health benefits. NRECA removed the annual benefit limit on pediatric dental services to comply with this requirement.

For a full list of covered services, review your summary plan description (SPD). For questions about dental plan benefits, participants should contact the Member Contact Center at 1.866.673.2299 or at contactcenter@nreca.coop.