Others titles

  • Certified Insurance Dental Plans
  • Health Insurance Metal Plans in Market

Keywords

  • Health Care
  • Health Insurance
  • Health Dental Plans
  • Adults Health Care Coverage
  • Age Groups and Health Care Coverage
  • Primary Care Physician
  • Dental Plans in Market
  • Health Premiums
  • Health Dental Plans

Quality Dental Plans in Market

This dataset shows 2019 individual and family dental plans available in states where the federal government is operating the Marketplace. States not represented in the dataset runs their own Marketplaces.

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Last updated:January 20, 2021

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Description

This dataset contains information on certified medical plans offered through an Exchange to consumers in the individual market. These plans are also known as Qualified Health Plans (QHPs). The document reports plans offered by county for states in the Federally-facilitated Exchanges, State Partnership Exchanges and State Based Exchanges using the federal platform for eligibility and enrollment.

Premium amounts do not include tax credits that will lower premiums for many consumers applying for insurance, specifically those with income up to 400 percent of the federal poverty level.

The dataset also shows standard cost sharing information for each plan. Cost sharing information is shown for in-network services, and includes:
• Deductibles: For in-network medical care and drugs (by individual, family)
• Maximum out of pocket expenses: For in-network medical care and drugs (by individual, family)
• Copayments and coinsurance for the following in-network services:
o Primary care physician
o Specialist
o Emergency Room
o Inpatient facility
o Inpatient physician
o Generic drugs
o Preferred brand drugs
o Non-preferred brand drugs
o Specialty drugs

About this Dataset

Data Info

Date Created

2016-06-23

Last Modified

2022-05-04

Version

2022-05-04

Update Frequency

Annual

Temporal Coverage

2019-01-01 to 2022-05-04

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Health Care, Health Insurance, Health Dental Plans, Adults Health Care Coverage, Age Groups and Health Care Coverage, Primary Care Physician, Dental Plans in Market, Health Premiums, Health Dental Plans

Other Titles

Certified Insurance Dental Plans, Health Insurance Metal Plans in Market

Data Fields

Name Description Type Constraints
State_AbbreviationState abbreviation for which dental plan is offeredstring-
FIPS_CodeFIPS county code is a five-digit Federal Information Processing Standards (FIPS) code which uniquely identifies counties and county equivalents in the United Statesintegerlevel : Nominal
CountyName of the county where health plan is offeredstring-
Health_Plan_LevelCategory of health plan level offered (High and Low)string-
Issuer_NameName of the insurance company who are offering health plansstring-
HIOS_Issuer_IDThe Health Insurance Oversight System (HIOS) is responsible for collecting issuer general identification information.integerlevel : Nominal
Plan_IDA unique identification number assigned to health planstring-
Plan_Marketing_NameName of the plan in the marketstring-
Plan_TypeType of plan (EPO= Exclusive Provider Organization, HMO= Health Maintenance Organization, PPO= Preferred Provider Organization, Indemnity)string-
Rating_AreaUnder the Affordable Care Act each state has submitted a plan to divide up the areas of the state into locations called rating areasstring-
Child_Only_OfferingHealth plan offered (Allows Adult and Child-Only, Allows Adult-Only)string-
SourceSource name which uses web-based application softwarestring-
Customer_Service_Phone_Number_LocalPhone number of the local customer service helplinestring-
Customer_Service_Phone_Number_Toll_FreeToll free service helpline for customersstring-
Customer_Service_Phone_Number_TTYText Phone number which is used mostly by deaf customersstring-
Network_URLWeb link of the health plan offeredstring-
Plan_Brochure_URLBrochure of health plan on Web URLstring-
Summary_of_Benefits_URLSummary benefits of health plan on web URLstring-
Is_Basic_Adult_Dental_CareAdult basic dental coverage in health planboolean-
Is_Basic_Child_Dental_CareChildren basic dental coverage in health planboolean-
Premium_Child_Age_0_to_14Premium amount for one child from age 0 to 14number-
Premium_Child_Age_18Premium amount for one child age 18number-
Premium_Adult_Individual_Age_21Premium amount for individual adult one child age 21number-
Premium_Adult_Individual_Age_27Premium amount for individual adult one child age 27number-
Premium_Adult_Individual_Age_30Premium amount for individual adult one child age 30number-
Premium_Adult_Individual_Age_40Premium amount for individual adult one child age 40number-
Premium_Adult_Individual_Age_50Premium amount for individual adult one child age 50number-
Premium_Adult_Individual_Age_60Premium amount for individual adult one child age 60number-
Premium_Couple_21Premium amount for couple (two adults, no child) age 21number-
Premium_Couple_30Premium amount for couple (two adults, no child) age 30number-
Premium_Couple_40Premium amount for couple (two adults, no child) age 40number-
Premium_Couple_50Premium amount for couple (two adults, no child) age 50number-
Premium_Couple_60Premium amount for couple (two adults, no child) age 60number-
Couple_Plus_1_Child_Age_21Premium amount for couple (two adults, one child) age 21number-
Couple_Plus_1_Child_Age_30Premium amount for couple (two adults, one child) age 30number-
Couple_Plus_1_Child_Age_40Premium amount for couple (two adults, one child) age 40number-
Couple_Plus_1_Child_Age_50Premium amount for couple (two adults, one child) age 50number-
Couple_Plus_2_Child_Age_21Premium amount for couple (two adults, two children) age 21number-
Couple_Plus_2_Child_Age_30Premium amount for couple (two adults, two children) age 30number-
Couple_Plus_2_Child_Age_40Premium amount for couple (two adults, two children) age 40number-
Couple_Plus_2_Child_Age_50Premium amount for couple (two adults, two children) age 50number-
Couple_Plus_3_Child_Age_21Premium amount for couple (two adults, three or more children) age 21number-
Couple_Plus_3_Child_Age_30Premium amount for couple (two adults, three or more children) age 30number-
Couple_Plus_3_Child_Age_40Premium amount for couple (two adults, three or more children) age 40number-
Couple_Plus_3_Child_Age_50Premium amount for couple (two adults, three or more children) age 50number-
Individual_Plus_1_Child_Age_21Premium amount for individual plus one child age 21number-
Individual_Plus_1_Child_Age_30Premium amount for individual plus one child age 30number-
Individual_Plus_1_Child_Age_40Premium amount for individual plus one child age 40number-
Individual_Plus_1_Child_Age_50Premium amount for individual plus one child age 50number-
Individual_Plus_2_Child_Age_21Premium amount for individual plus two children age 21number-
Individual_Plus_2_Child_Age_30Premium amount for individual plus two children age 30number-
Individual_Plus_2_Child_Age_40Premium amount for individual plus two children age 40number-
Individual_Plus_2_Child_Age_50Premium amount for individual plus two children age 50number-
Individual_Plus_3_Child_Age_21Premium amount for individual plus three children or more age 21number-
Individual_Plus_3_Child_Age_30Premium amount for individual plus three children or more age 30number-
Individual_Plus_3_Child_Age_40Premium amount for individual plus three children or more age 40number-
Individual_Plus_3_Child_Age_50Premium amount for individual plus three children or more age 50number-
Dental_Deductible_Individual_StandardDeductible amount for in-network dental care by individual standardnumber-
Dental_Deductible_Family_StandardDeductible amount for in-network dental care by family standardstring-
Dental_Deductible_Family_Per_Person_StandardDeductible amount for in-network dental care by per person standardnumber-
Dental_Maximum_Out_of_Pocket_Individual_Standardnumber-
Dental_Maximum_Out_of_Pocket_Family_Standardnumber-
Dental_Maximum_Out_of_Pocket_Family_Per_Person_Standardnumber-

Data Preview

State AbbreviationFIPS CodeCountyHealth Plan LevelIssuer NameHIOS Issuer IDPlan IDPlan Marketing NamePlan TypeRating AreaChild Only OfferingSourceCustomer Service Phone Number LocalCustomer Service Phone Number Toll FreeCustomer Service Phone Number TTYNetwork URLPlan Brochure URLSummary of Benefits URLIs Routine Dental ServicesIs Basic Adult Dental CareIs Major Adult Dental CareIs Orthodontia AdultIs Dental Check Up for ChildrenIs Basic Child Dental CareIs Major Child Dental CareIs Orthodontia ChildPremium Child Age 0 to 14Premium Child Age 18Premium Adult Individual Age 21Premium Adult Individual Age 27Premium Adult Individual Age 30Premium Adult Individual Age 40Premium Adult Individual Age 50Premium Adult Individual Age 60Premium Couple 21Premium Couple 30Premium Couple 40Premium Couple 50Premium Couple 60Couple Plus 1 Child Age 21Couple Plus 1 Child Age 30Couple Plus 1 Child Age 40Couple Plus 1 Child Age 50Couple Plus 2 Child Age 21Couple Plus 2 Child Age 30Couple Plus 2 Child Age 40Couple Plus 2 Child Age 50Couple Plus 3 Child Age 21Couple Plus 3 Child Age 30Couple Plus 3 Child Age 40Couple Plus 3 Child Age 50Individual Plus 1 Child Age 21Individual Plus 1 Child Age 30Individual Plus 1 Child Age 40Individual Plus 1 Child Age 50Individual Plus 2 Child Age 21Individual Plus 2 Child Age 30Individual Plus 2 Child Age 40Individual Plus 2 Child Age 50Individual Plus 3 Child Age 21Individual Plus 3 Child Age 30Individual Plus 3 Child Age 40Individual Plus 3 Child Age 50Dental Deductible Individual StandardDental Deductible Family StandardDental Deductible Family Per Person StandardDental Maximum Out of Pocket Individual StandardDental Maximum Out of Pocket Family StandardDental Maximum Out of Pocket Family Per Person StandardRoutine Dental Services AdultBasic Dental Care AdultMajor Dental Care AdultOrthodontia AdultDental Check Up for ChildrenBasic Dental Care ChildMajor Dental Care ChildOrthodontia Child
AK2013Aleutians EastLowOregon Dental Service2198921989AK0030001Delta Dental Premier PlanIndemnityRating Area 2Allows Adult and Child-OnlyHIOS1-844-235-80141-844-235-80141-844-235-8014https://www.modahealth.com/ProviderSearch?productCategory=dental&selectedNetwork=Delta Dental Premier&state=AKhttps://www.modahealth.com/pdfs/plans/individual/Moda_DeltaDentalPremierPlan_2019_AK.pdfTrueTrueTrueTrueTrueTrueTrue55.555.542.042.042.042.042.046.084.084.084.084.092.0139.5139.5139.5139.5195.0195.0195.0195.0250.5250.5250.5250.597.597.597.597.5153.0153.0153.0153.0208.5208.5208.5208.500035070035020%35%50%Not Covered30%70%70%70%
AK2013Aleutians EastHighBEST Life and Health Insurance Company7481974819AK0020003BESTOne Advantage GoldPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Advantage-Gold_Plan.pdfTrueTrueTrueTrueTrueTrueTrue51.3451.3455.4559.2459.2459.2459.2459.24110.9118.48118.48118.48118.48162.24169.82169.82169.82213.58221.16221.16221.16264.92272.5272.5272.5106.79110.58110.58110.58158.13161.92161.92161.92209.47213.26213.26213.265015050350700350No Charge10% Coinsurance after deductible50% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%
AK2013Aleutians EastHighBEST Life and Health Insurance Company7481974819AK0020004BESTOne Plus GoldPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Plus-Gold_Plan.pdfTrueTrueTrueTrueTrueTrueTrue51.3451.3446.1149.2649.2649.2649.2649.2692.2298.5298.5298.5298.52143.56149.86149.86149.86194.9201.2201.2201.2246.24252.54252.54252.5497.45100.6100.6100.6148.79151.94151.94151.94200.13203.28203.28203.285015050350700350No Charge30% Coinsurance after deductible60% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%
AK2013Aleutians EastLowBEST Life and Health Insurance Company7481974819AK0020005BESTOne Plus SilverPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Plus-Silver_Plan.pdfTrueTrueTrueTrueTrueTrueTrue39.7339.7343.8746.8746.8746.8746.8746.8787.7493.7493.7493.7493.74127.47133.47133.47133.47167.2173.2173.2173.2206.93212.93212.93212.9383.686.686.686.6123.33126.33126.33126.33163.06166.06166.06166.0675See Plan Brochure75350700350No Charge30% Coinsurance after deductible60% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%
AK2013Aleutians EastLowBEST Life and Health Insurance Company7481974819AK0020006BESTOne Basic SilverPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Basic-Silver_Plan.pdfTrueTrueTrueTrueTrueTrueTrue39.7339.7331.5233.6833.6833.6833.6833.6863.0467.3667.3667.3667.36102.77107.09107.09107.09142.5146.82146.82146.82182.23186.55186.55186.5571.2573.4173.4173.41110.98113.14113.14113.14150.71152.87152.87152.8775See Plan Brochure75350700350No Charge50% Coinsurance after deductible70% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%
AK2016Aleutians WestLowOregon Dental Service2198921989AK0030001Delta Dental Premier PlanIndemnityRating Area 2Allows Adult and Child-OnlyHIOS1-844-235-80141-844-235-80141-844-235-8014https://www.modahealth.com/ProviderSearch?productCategory=dental&selectedNetwork=Delta Dental Premier&state=AKhttps://www.modahealth.com/pdfs/plans/individual/Moda_DeltaDentalPremierPlan_2019_AK.pdfTrueTrueTrueTrueTrueTrueTrue55.555.542.042.042.042.042.046.084.084.084.084.092.0139.5139.5139.5139.5195.0195.0195.0195.0250.5250.5250.5250.597.597.597.597.5153.0153.0153.0153.0208.5208.5208.5208.500035070035020%35%50%Not Covered30%70%70%70%
AK2016Aleutians WestHighBEST Life and Health Insurance Company7481974819AK0020003BESTOne Advantage GoldPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Advantage-Gold_Plan.pdfTrueTrueTrueTrueTrueTrueTrue51.3451.3455.4559.2459.2459.2459.2459.24110.9118.48118.48118.48118.48162.24169.82169.82169.82213.58221.16221.16221.16264.92272.5272.5272.5106.79110.58110.58110.58158.13161.92161.92161.92209.47213.26213.26213.265015050350700350No Charge10% Coinsurance after deductible50% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%
AK2016Aleutians WestHighBEST Life and Health Insurance Company7481974819AK0020004BESTOne Plus GoldPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Plus-Gold_Plan.pdfTrueTrueTrueTrueTrueTrueTrue51.3451.3446.1149.2649.2649.2649.2649.2692.2298.5298.5298.5298.52143.56149.86149.86149.86194.9201.2201.2201.2246.24252.54252.54252.5497.45100.6100.6100.6148.79151.94151.94151.94200.13203.28203.28203.285015050350700350No Charge30% Coinsurance after deductible60% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%
AK2016Aleutians WestLowBEST Life and Health Insurance Company7481974819AK0020005BESTOne Plus SilverPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Plus-Silver_Plan.pdfTrueTrueTrueTrueTrueTrueTrue39.7339.7343.8746.8746.8746.8746.8746.8787.7493.7493.7493.7493.74127.47133.47133.47133.47167.2173.2173.2173.2206.93212.93212.93212.9383.686.686.686.6123.33126.33126.33126.33163.06166.06166.06166.0675See Plan Brochure75350700350No Charge30% Coinsurance after deductible60% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%
AK2016Aleutians WestLowBEST Life and Health Insurance Company7481974819AK0020006BESTOne Basic SilverPPORating Area 2Allows Adult and Child-OnlyHIOS1-949-253-40801-800-433-00881-949-222-2134http://www.bestlife.com/Provider_Search/https://www.bestlife.com/ak/current/AK_BESTOne_Dental_Basic-Silver_Plan.pdfTrueTrueTrueTrueTrueTrueTrue39.7339.7331.5233.6833.6833.6833.6833.6863.0467.3667.3667.3667.36102.77107.09107.09107.09142.5146.82146.82146.82182.23186.55186.55186.5571.2573.4173.4173.41110.98113.14113.14113.14150.71152.87152.87152.8775See Plan Brochure75350700350No Charge50% Coinsurance after deductible70% Coinsurance after deductibleNot CoveredNo Charge30% Coinsurance after deductible50% Coinsurance after deductible50%