As of January 1, 2014, most Americans are required to maintain minimum essential coverage or pay a penalty. Employers with at least 50 or more full-time employees that are not currently offering minimum essential coverage to employees may have to provide or pay a penalty. Minimum essential coverage includes pediatric dental coverage for children up to age 19 and uses either the state's Children's Health Insurance Program (CHIP) or the Federal Employee Dental and Vision Program (FEDVIP) as its benchmark.
The Patient Protection and Affordable Care Act (PPACA) was designed to increase access to health care and plan participation. The pediatric dental coverage requirement has resulted in an increase in dental plan enrollment and utilization. A significant portion of children also gain dental benefits outside of the health insurance exchanges through insurers including Dominion, through private insurance brokers, employers or through the health insurance exchange marketplaces.