CHICAGO, Jan. 30, 2024 – The National Council of Insurance Legislators (NCOIL) recently adopted model legislation (PDF) for a medical loss ratio (MLR) in dentistry, with language agreed to by the American Dental Association (ADA) and the National Association of Dental Plans (NADP). The model legislation provides an agreed-upon starting point for the introduction of state bills across the country in 2024, while leaving the door open for states to find the optimal solution for their constituents.
A Dental Loss Ratio requires dental insurance companies to pay a set percentage of premiums collected on actual patient care. Under a Dental Loss Ratio, insurance companies would also be required to refund to insured patients a part of the premium collected if the insurance companies fail to meet the set percentage. Dental Loss Ratios also require insurance companies to be more transparent in their reporting of how much they spend on patient care. Without a Dental Loss Ratio, insurance companies can keep the unspent premiums as profit to be used for marketing, salaries or other company overhead, rather than on patient care.
Source: State Legislators’ Group Adopts Medical Loss Ratio Model Legislation for Dentistry / ADA.org