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Stand Alone Dental Plans - Formulary Guidance

Question:

Should the plans.json file include SADPs? If the answer is yes, it is our understanding that formulary does not apply to SADPs, so how would be handle the required formulary related fields on the plans.json file? Would we leave those fields blank?

Answer:

SADPs should be included in the plans.json file. We are aware that there are some required fields that you may not have, and at this time they should be left blank or included as a json null. 

Example of SADP formulary plans.json that will pass validation:

        "formulary":
        {
            "drug_tier": null,

            "cost_sharing": [
                {
                    "pharmacy_type": null,
                    "copay_amount": null,
                    "copay_opt": null,
                    "coinsurance_rate": null,
                    "coinsurance_opt": null
                }
            ]
        },




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