MI| The Michigan Department of Insurance and Financial Services (DIFS) Bulletin 2025-09-INS details the 2026 form and rate filing requirements for Stand-Alone Dental Plans (SADPs) offered both on- and off-Marketplace. Issuers must adhere to updated certification, submission, and documentation standards, including using enrollees’ age at policy issuance or renewal for rating, submitting guaranteed rates, and complying with new annual cost-sharing limits of $450 for one child and $900 for two or more children. The bulletin outlines strict deadlines, template requirements, and procedural updates for plan certification, recertification, and withdrawal, while emphasizing compliance with federal and state regulations, network adequacy, and consumer protections.
Key Points:
- The annual cost-sharing maximums for 2026 are set at $450 for one child and $900 for two or more children, applicable to Marketplace-certified SADPs.
- Issuers must submit all required forms, rates, and supporting documentation via SERFF by May 1, 2025, and comply with detailed template validation, naming conventions, and checklist requirements.
- All SADPs must meet network adequacy, readability, grievance procedure, and dependent coverage standards, and only Marketplace-certified plans can be considered as providing Essential Health Benefits for pediatric dental coverage.