45 CFR § Contract must identify and provide contact information for the responsible Discrimination 92.8(a)(5) employee designated to coordinate its nondiscrimination efforts, including (Cont’d) complaints. 45 CFR § Contract must notify enrollee of the availability of the grievance procedure 92.8(a)(6) and how to file a grievance, and how to file a discrimination complaint with and (7) the federal Office of Civil Rights. Taglines 45 CFR § Contract must include taglines in at the top 15 languages spoken by 92.8(d)(1) individuals with limited English proficiency of the relevant State or States. Requirement Pediatric Oral ATTENTION: Plans sold on the Exchange CAN NOT contain Pediatric 42 USC Services (EHB) to Cover Dental benefits as an embedded set of benefits. §1802(a)(1)(B) Pediatric Oral Requirement A health plan sold outside the Exchange may include pediatric dental 42 USC Services (EHB) to Cover benefits as an embedded set of benefits, or through a combination of a 18022(b)(1)(J) Pediatric Oral health benefit plan and a stand-alone dental plan that includes pediatric Services dental benefits certified as a qualified dental plan. WAC 284-43-5760. (Cont’d) Plan must satisfy the requirement in one of two ways: The plan includes pediatric dental benefits as an embedded benefit WAC “2017 (issuer must submit the ALL FILERS Individual EMBEDDED Pediatric Dental EHBs Analyst Checklist” in addition to this checklist); or The plan does not have pediatric dental benefits, and the issuer receives WAC reasonable assurance that the applicant has obtained or will obtain pediatric dental benefits through a stand-alone QDP. This reasonable assurance must be received by the issuer within 60 days. Pediatric Vision WAC Requirement Plan must cover pediatric vision services as an embedded set of Services (EHB) for Coverage - 2) services.
(Cont’d) 45 CFR § 92.8(a)(5) Contract must identify and provide contact information for the responsible employee designated to coordinate its nondiscrimination efforts, including complaints. 45 CFR § 92.8(a)(6) and (7) Contract must notify enrollee of the availability of the grievance procedure and how to file a grievance, and how to file a discrimination complaint with the federal Office of Civil Rights. Taglines 45 CFR § 92.8(d)(1) Contract must include taglines in at the top 15 languages spoken by individuals with limited English proficiency of the relevant State or States. Pediatric Oral Services (EHB) Pediatric Oral Services (EHB) Requirement to Cover Requirement to Cover Pediatric Oral Services (Cont’d) 42 USC §1802(a)(1)(B) 42 USC 18022(b)(1)(J) ATTENTION: Plans sold on the Exchange CAN NOT contain Pediatric Dental benefits as an embedded set of benefits. A health plan sold outside the Exchange may include pediatric dental benefits as an embedded set of benefits, or through a combination of a health benefit plan and a stand-alone dental plan that includes pediatric dental benefits certified as a qualified dental plan. WAC 284-43-5760. WAC Plan must satisfy the requirement in one of two ways: The plan includes pediatric dental benefits as an embedded benefit (issuer must submit the “2017 ALL FILERS Individual EMBEDDED Pediatric Dental EHBs Analyst Checklist” in addition to this checklist); or WAC The plan does not have pediatric dental benefits, and the issuer receives reasonable assurance that the applicant has obtained or will obtain pediatric dental benefits through a stand-alone QDP. This reasonable assurance must be received by the issuer within 60 days. Pediatric Vision Services (EHB) Requirement for Coverage WAC - 2) Plan must cover pediatric vision services as an embedded set of services. Discrimination
cl-forms-19-hmo-ind-analyst-checklist.docx