Dental Plans Medical Loss Ratio

The act requires a health insurance carrier (carrier) that issues, sells, renews, or offers a dental coverage plan to file, beginning in 2024, dental loss ratio forms with the division of insurance (division) for the preceding calendar year in which dental coverage was provided.

The division is required to post dental loss ratio information on its website or submit the information to the administrator of the all-payer health claims database (APCD). If the information is submitted to the APCD administrator, the administrator is directed to make the information available to the public.

Once the division has collected dental loss ratio information for 2 years, the commissioner of insurance (commissioner) shall promulgate rules that create a process to identify any carriers that significantly deviate from average dental loss ratios and to investigate the causes of the deviation.

The act requires the commissioner to adopt rules that require each carrier that provides a dental coverage plan to issue to covered persons to whom a dental coverage plan identification card is issued a standardized written or virtual card containing plan information.

The act also requires prepaid dental plans to file rates with the division.

The act appropriates $64,252 from the division of insurance cash fund to the department of regulatory agencies for use by the division of insurance for personal services and operating expenses.

APPROVED by Governor June 2, 2023

EFFECTIVE August 7, 2023

NOTE: This act was passed without a safety clause and takes effect 90 days after sine die.
(Note: This summary applies to this bill as enacted.)