Dental loss ratio model legislation gets a nod

The National Council of Insurance Legislators, a group of state lawmakers focused on insurance law, adopted model legislation for a dental loss ratio, with language approved by the American Dental Association and National Association of Dental Plans.

The model provides the base for the introduction of dental loss ratio state bills while still giving each state the ability to tailor the legislation, according to a Jan. 30 news release from the ADA. 

Dental and medical loss ratios require insurers to spend a set percentage of premiums on patient care instead of operational costs. A dental loss ratio would also require insurance companies to refund patients part of the premium if the percentage is not hit and increase transparency in companies' reporting. 

The model legislation, among other things, includes a provision that sets a loss ratio on plans that have low loss ratios year after year, protections from dental plans increasing prices solely based off of dental loss ratio requirements, and reporting and transparency standards akin to the medical loss ratio put in place under the Affordable Care Act, the release said.

In 2024, nine different state dental societies have introduced dental loss ratio legislation.

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