Quality Dental Plans in Market

$79 / year

This dataset shows 2018 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.

Complexity

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

Date Created

2016-06-23

Last Modified

2018-07-09

Version

2018-07-09

Update Frequency

Annual

Temporal Coverage

2018-01-01 to 2018-12-31

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare and Medicaid Services

Source License URL

John Snow Labs Standard License

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

NameDescriptionTypeConstraints
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_Routine_Dental_ServicesAdult dental coverage in health planboolean-
Is_Basic_Adult_Dental_CareAdult basic dental coverage in health planboolean-
Is_Major_Adult_Dental_CareAdult major dental coverage in health planboolean-
Is_Orthodontia_AdultOrthodontia dental coverage in health planboolean-
Is_Dental_Check_Up_for_ChildrenChildren dental coverage in health planboolean-
Is_Basic_Child_Dental_CareChildren basic dental coverage in health planboolean-
Is_Major_Child_Dental_CareChildren major dental coverage in health planboolean-
Is_Orthodontia_ChildChild orthodontia 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-
Routine_Dental_Services_AdultCopayments and coinsurance for the adult routine dental services in-network servicesstring-
Basic_Dental_Care_AdultCopayments and coinsurance for the adult basic dental services in-network servicesstring-
Major_Dental_Care_AdultCopayments and coinsurance for the adult major dental services in-network servicesstring-
Orthodontia_AdultCopayments and coinsurance for the Orthodontia adults in-network servicesstring-
Dental_Check_Up_for_ChildrenCopayments and coinsurance for the children dental check up in-network servicesstring-
Basic_Dental_Care_ChildCopayments and coinsurance for the basic children dental services in-network servicesstring-
Major_Dental_Care_ChildCopayments and coinsurance for the major children dental services in-network servicesstring-
Orthodontia_ChildCopayments and coinsurance for the Orthodontia child in-network servicesstring-
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
NJ34013EssexHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34029OceanHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34033SalemHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34039UnionHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34003BergenHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34007CamdenHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34017HudsonHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34021MercerHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34027MorrisHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%
NJ34037SussexHighHorizon Healthcare Services, Inc.9166191661NJ2310001Horizon Young GrinsPPORating Area 1Allows Child-OnlyHealth Insurance Oversight System1-866-260-38521-866-260-38521-800-852-7899http://doctorfinder.horizonblue.com/truetruetruetrue30.7629.04100$200350700350Not CoveredNot CoveredNot CoveredNot CoveredNo Charge after Deductible20% Coinsurance after deductible50% Coinsurance after deductible50%