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Dental and vision as excepted benefits under HIPAA


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HIPAA does not apply to limited scope dental and vision benefits. However, under IRS and DOL regs., a dental or vision plan IS subject to HIPAA unless (among other things) employees are charged a separate amount for participation in the dental or vision plan. So, if the employer carries the entire cost of coverage, its dental plan would be subject to HIPAA. It matters in that some dental programs have preexisting condition limitations on e.g. the replacement of missing teeth.

My question is -- Have you heard anything about the IRS and DOL revising the definition of "limited scope" dental and vision benefits under DOL 2590.732(B)(3)?

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