Py-17 version 2. 15a-1 2017 qhp application instructions . chapter 15a: stand-alone dental plan actuarial value supporting documentation and justification. All supporting documentation and justification documents can be found at . stand-alone dental plan actuarial value supporting documentation and justification . describes the methods used to calculate actuarial value. required for all stand-alone dental plan issuers . submission .. Stand-alone dental plan actuarial value supporting documentation and justification document required for sadps that intend to be certified by the federally-facilitated marketplace (ffm) •attach to the supporting documentation tab in serff must be submitted with any federal exchange certified sadp policy form filing that includes pediatric dental.
Applicant attests that any stand-alone dental plans offered will adhere to the standards set forth by hhs for the administration of advance payments of the premium tax credit. yes n/a stand-alone dental plan actuarial value supporting documentation and justification complete the form as provided.. Stand - alone dental plan actuarial value supporting documentation and justification stand - alone dental plans - description of ehb allocation unique plan design justification conditional ehb-substituted benefit (actuarial equivalent) justification conditional discrimination-cost sharing outlier justification conditional. Discrimination – cost sharing outlier supporting documentation and justification unique plan design – supporting documentation and justification stand-alone dental plan actuarial value supporting documentation stand-alone dental plans – description of ehb allocation rates template business rules template ..
