Summary of Dental Benefits and Coverage (SDBC) Coming Soon
Approved by Governor Newsom on September 29, 2018, California's SB 1008 requires health plans and health insurance policies that cover dental services to utilize a uniform health plan benefits and coverage matrix. This Summary of Dental Benefits and Coverage Matrix (SDBC) requirement is similar to the current SBCs required for medical coverage.
Template
A uniform summary of benefits and coverage will be provided to health insurers to complete and provide to enrollees. This template includes a variety of information to help enrollees assess their options and understand their plan, including:
- Deductible and annual maximum
- Coverage for preventive and diagnostic services, basic services, major services, orthodontia services
- Dental plan reimbursement levels and estimated enrollee cost share for services
- Waiting periods
- Examples to illustrate coverage and estimated costs of commonly used benefits, including:
- Preventive and diagnostic services
- Basic services
- Major services
Timing of Notices
Much like SBCs for medical coverage, SDBCs will be required to be disseminated to dental enrollees:
- Enrolling in dental coverage
- Experiencing a special enrollment event
- Renewing coverage
- Upon request
Adopting & Effective Date
The SDBC requirements are to take effect for plan or policy years on and after January 1, 2021, or 12 months after adoption of the emergency regulations, whichever occurs later. While COVID-19 regulations have delayed these requirements, some carriers have already begun providing SDBCs. For example, click here to see Guardian's SDBC for their J1 Nap with Ortho plan.
How to Find SDBCs on the B&P Website
You can find a zip file containing all the SDBCs for a particular carrier under the Dental category of the Plan Details section for each carrier. This is in the same section as you would find the benefit summaries for dental plans.
Resources
B&P will be posting SDBCs for our carriers soon (as they become available).
For questions about this new requirement, please contact your B&P Sales Rep - 888.722.3373.