ANALYST CHECKLIST DISABILITY COMPANY GROUP STAND ALONE DENTAL PLANS – Issuer: _________________________ Tracking Number: __________________ For plan years beginning on or after 1/1/2017, the base-benchmark plan for Pediatric Oral Care Essential Health Benefits is the Regence BlueShield Note: Regence Direct Gold small group plan, policy form number WW0114CCONMSD, and certificate form number WW0114BPPO1SD, offered during the first quarter of 2014 (SERFF filing number Where reference is made to that plan (“Benchmark Plan”), additional detail is provided in the plan regarding a particular benefit than is provided in the Essential Health Benefits regulation, WAC 284-43-5702. GENERAL REVIEW REQUIREMENTS Authority to Review Contract – RCW 48.18.100, WAC 284-43-6560; WAC 284-58-030 Sub topic Reference Specific Issue Form # Additional and page Information or section Continuation RCW Labor 48.21.075 Contract must allow for the employee to pay premiums directly to Dispute the contract holder, not to exceed 6 months, in the event that the of Care During employee’s compensation is suspended as the result of strike, Enrollee out or other labor dispute. Absence Applies whether employer pays all or part of premium Continuation Labor All three actions (strike, lockout, other labor dispute) must appear During Dispute in description provisions.
ANALYST CHECKLIST DISABILITY COMPANY – GROUP STAND ALONE DENTAL PLANS Issuer: _________________________ Tracking Number: __________________ Note: For plan years beginning on or after 1/1/2017, the base-benchmark plan for Pediatric Oral Care Essential Health Benefits is the Regence BlueShield Regence Direct Gold small group plan, policy form number WW0114CCONMSD, and certificate form number WW0114BPPO1SD, offered during the first quarter of 2014 (SERFF filing number Where reference is made to that plan (“Benchmark Plan”), additional detail is provided in the plan regarding a particular benefit than is provided in the Essential Health Benefits regulation, WAC 284-43-5702. GENERAL REVIEW REQUIREMENTS Authority to Review Contract – RCW 48.18.100, WAC 284-43-6560; WAC 284-58-030 Sub topic Reference Specific Issue Form # and page or section Additional Information Continuation of Care During Enrollee Absence Continuation During Labor Dispute Labor Dispute RCW 48.21.075 Contract must allow for the employee to pay premiums directly to the contract holder, not to exceed 6 months, in the event that the employee’s compensation is suspended as the result of strike, or other labor dispute. Applies whether employer pays all or part of premium All three actions (strike, lockout, other labor dispute) must appear in description provisions. out