(a) Annual limitation on cost-sharing. For a stand-alone dental plan covering the pediatric dental EHB under Sec. 155.1065 of this subchapter in any Exchange, cost sharing may not exceed $350 for one covered child and $700 for two or more covered children.
(b) Calculation of AV. A stand-alone dental plan:
(1) May not use the AV calculator in Sec. 156.135 of this subpart;
(2) Must demonstrate that the stand-alone dental plan offers the pediatric dental essential health benefit at either:
(i) A low level of coverage with an AV of 70 percent; or
(ii) A high level of coverage with an AV of 85 percent; and
(iii) Within a de minimis variation of 2 percentage points of the level of coverage in paragraphs (b)(2)(i) or (ii) of this section.
(3) The level of coverage as defined in paragraph (b)(2) of this section must be certified by a member of the American Academy of Actuaries using generally accepted actuarial principles. [78 FR 12866, Feb. 25, 2013, as amended at 79 FR 13840, Mar. 11, 2014]