The main requirement of Health Care Reform legislation applicable to MetLife's dental products is individuals and small employer groups (generally under 50 employees, but in some states, under 100 employees) must offer essential dental care to individuals to age 19 ("Pediatric Dental Benefits").
For these businesses, medical carriers have been required to offer a medical plan consisting of defined essential health benefits. However, the law allows for the essential benefits for dental to be provided by a stand-alone dental carrier as well. Medical carriers may sell products that do not include pediatric dental coverage if medical carriers are "reasonably assured" that employers have attained stand-alone dental coverage.
There are 10 categories of essential health benefits, including ambulatory patient services, hospitalization, maternity and newborn care and more. Pediatric dental benefits for children up to age 19 are part of the essential health benefits.
Insurance exchanges (or marketplaces) were created where medical and dental coverage can be purchased by employers and individuals. MetLife is permitted to provide Pediatric Dental Benefits within the insurance exchanges. However, it's important to note that these pediatric dental benefits do not have to be purchased on the exchanges - they can be purchased off the exchanges in the same manner in which dental benefits are purchased today.