December 2010 Health Care Reform Insights, "Impact of the Affordable Care Act on Dental and Vision Benefits"


The Affordable Care Act (the abbreviated name for the Patient Protection and Affordable Care Act as modified by the subsequently enacted Health Care and Education Reconciliation Act), imposes significant new requirements on group health plans, including "grandfathered" plans (those plans in existence when the law was enacted). Guidance from the agencies implementing the Affordable Care Act confirms that:

  • Plans providing insured dental and vision benefits are not subject to the Affordable Care Act.
  • Plans that are self-insured but subject to an employee election and employee contributions are not subject to the Act.
  • Self-insured dental and vision benefits that are not separately elected and do not have separate employee contributions must comply with the Affordable Care Act.

This issue of Health Care Reform Insights addresses how those requirements, including the mandate to continue coverage of children up to age 26 and the ban on lifetime dollar limits, affect dental and vision benefits offered by group health plans.

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