NCOIL Panel Creates Model for State Dental Loss Ratio Laws
States now have a template they can use to change the way dental insurance works.
The National Council of Insurance Legislators said Wednesday that its Health Insurance & Long Term Care Insurance Issues Committee has approved a model act that includes rules for dental plan medical loss ratios.
The new NCOIL dental loss ratio model would push dental insurers to spend at least as much as their competitors on care.
What it means: Clients could have an easier time shopping for high-value dental insurance.
The history: Today, many dental plans spend only about 60% to 75% of their premium revenue on patient care, quality improvement efforts and other, closely related items, and a few plans spend less than 20% of their premium revenue on care, according to the American Dental Association.
Massachusetts voters approved a minimum dental loss ratio law ballot measure for their state in November 2022, according to the ADA.
Arizona, Colorado and Nevada have their own homegrown minimum DLR laws in 2023.
An earlier version of the model was based on the Affordable Care Act minimum medical loss ratio rules. The ACA requires large plans to spend at least 85% of premium revenue on care or pay rebates, and it requires issuers of individual coverage and small-group policies to spend at least 80% of premium revenue on care or pay rebates.
