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Oklahoma Legislature· HB 2805Second Reading referred to Business and Insurance

An act relating to dental benefit plans, the official text

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1                            STATE OF OKLAHOMA

2         1st Session of the 60th Legislature (2025)

3 HOUSE BILL 2805            By: Marti

4

5

6                            AS INTRODUCED

7         An Act relating to dental benefit plans; defining

          terms; establishing formula for medical loss ratio;

8         requiring annual reporting to the Oklahoma Insurance

          Department; establishing process for certain data

9         verification; exempting certain dental plans from

          provisions of act; requiring annual rebate for

10        certain plan years by certain plans; providing for

          rebate calculation; prohibiting certain rate

11        establishment; directing rule promulgation;

          establishing provisions for rate determination by

12        Commissioner; requiring certain rate increase notice;

          amending 36 O.S. 2021, Section 7301, which relates to

13        dental plans; modifying definition; providing for

          codification; and providing an effective date.

14

15

16 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

17  SECTION 1.      NEW LAW  A new section of law to be codified

18 in the Oklahoma Statutes as Section 7140 of Title 36, unless there

19 is created a duplication in numbering, reads as follows:

20  A. As used in this act:

21  1. "Earned premium" means all monies paid by a policyholder or

22 subscriber as a condition of receiving coverage from the insurer,

23 including any fees or other contributions associated with the dental

24 plan;

    Req. No. 11307                                               Page 1
1   2. "Medical loss ratio (MLR)" means the percentage of all

2 premium funds collected by an insurer each year that shall be spent

3 on actual patient care rather than overhead costs; and

4   3. "Unpaid claim reserves" means reserves and liabilities

5 established to account for claims that were incurred during the MLR

6 reporting year but were not paid within three (3) months of the end

7 of the MLR reporting year.

8   B. The medical loss ratio for a dental plan or the dental

9 coverage portion of a health benefit plan shall be determined by

10 dividing the numerator by the denominator as defined in this

11 section.

12  C. 1. The numerator shall be the amount spent on care. The

13 amount spent on care shall include:

14           a. the amount expended for clinical dental services which

15           are services within the code on dental procedures and

16           nomenclature, provided to enrollees which includes

17           payments under capitation contracts with dental

18           providers, whose services are covered by the contract

19           for dental clinical services or supplies covered by

20           the contract; provided, any overpayment that has

21           already been received from providers shall not be

22           reported as a paid claim. Overpayment recoveries

23           received from providers shall be deducted from

24           incurred claim amounts,

    Req. No. 11307                                               Page 2
1   b. unpaid claim reserves, and

2   c. claim payments recovered by insurers from providers or

3   enrollees using utilization management efforts shall

4   be deducted from incurred claim amounts.

5   2. Calculation of the numerator shall not include:

6   a. all administrative costs, including, but not limited

7   to, infrastructure, personnel costs, or broker

8   payments,

9   b. amounts paid to third-party vendors for secondary

10  network savings,

11  c. amounts paid to third-party vendors for network

12  development, administrative fees, claims processing,

13  and utilization management, and

14  d. amounts paid to a provider for professional or

15  administrative services that do not represent

16  compensation or reimbursement for covered services to

17  an enrollee, including, but not limited to, dental

18  record copying costs, attorney fees, subrogation

19  vendor fees, compensation to paraprofessionals,

20  janitors, quality assurance analysts, administrative

21  supervisors, secretaries to dental personnel, and

22  dental record clerks.

23  D. The denominator shall include the total amount of the earned

24 premium revenues, excluding federal and state taxes and licensing

    Req. No. 11307                                        Page 3
1 and regulatory fees paid after accounting for any payments pursuant

2 to federal law.

3   E. 1. A dental benefit plan or the dental portion of a health

4 benefit plan that issues, sells, renews, or offers a specialized

5 health benefit plan contract covering dental services on or after

6 the effective date of this act shall file a medical loss ratio (MLR)

7 with the Oklahoma Insurance Department that is organized by market

8 and product type and, where appropriate, contains the same

9 information required in the 2013 federal Medical Loss Ratio Annual

10 Reporting Form (CMS-10418).

11  2. The MLR reporting year shall be for the calendar year during

12 which dental coverage is provided by the plan. All terms used in

13 the MLR annual report shall have the same meaning as used in the

14 federal Public Health Service Act, 42 U.S.C., Section 300gg-18, Part

15 158 of Title 45 of the Code of Federal Regulations.

16  F. 1. If data verification of the dental benefit plan or the

17 dental portion of a health benefit plan's representations in the MLR

18 annual report is deemed necessary, the Insurance Department shall

19 provide the health benefit plan with a notification thirty (30) days

20 before the commencement of the financial examination.

21  2. The dental benefit plan or the dental portion of a health

22 benefit plan shall have thirty (30) days from the date of

23 notification to submit to the Department all requested data. The

24

    Req. No. 11307                                            Page 4
1 Insurance Commissioner may extend the time for a health benefit plan

2 to comply with this subsection upon a finding of good cause.

3   G. The Insurance Department shall make available to the public

4 in a searchable format on a public website all of the data provided

5 to the Department pursuant to this section which allows members of

6 the public to compare dental loss ratios among carriers by plan

7 type.

8   H. The provisions of this act shall not apply to health benefit

9 plans under Medicaid.

10  SECTION 2.      NEW LAW      A new section of law to be codified

11 in the Oklahoma Statutes as Section 7141 of Title 36, unless there

12 is created a duplication in numbering, reads as follows:

13  A. 1. A dental benefit plan or the dental portion of a health

14 benefit plan that issues, sells, renews, or offers a specialized

15 health care service plan contract covering dental services on or

16 after the effective date of this act shall provide an annual rebate

17 to each enrollee under that coverage, on a pro rata basis, if the

18 dental loss ratio Formula established in subsections C and D of

19 Section 1 of this act, is applied and the loss ratio is determined

20 to be less than, at minimum:

21       a. eighty-five percent (85%) for large group plans as

22              defined in 42 U.S.C., Section 18024(b)(2), and

23       b. eighty percent (80%) for individual and small group

24              plans as defined in 42 U.S.C., Section 18024(b)(2).

    Req. No. 11307                                                 Page 5
1   2. Dental benefit plans shall implement the provisions of

2 paragraph 1 of this subsection not later than January 1, 2028.

3   B. The total amount of an annual rebate required under this

4 section shall be calculated in an amount equal to the product of the

5 amount by which the percentage described in subsection A of this

6 section exceeds the insurer's reported ratio described in

7 subsections C and D of Section 1 of this act multiplied by the total

8 amount of premium revenue, excluding federal and state taxes and

9 licensing or regulatory fees and after accounting for payments or

10 receipts for risk adjustment, risk corridors, and reinsurance.

11  C. A dental benefit plan or the dental portion of a health

12 benefit plan shall provide any rebate owed to an enrollee no later

13 than August 1 of the calendar year following the year for which the

14 ratio described in subsection A of this section was calculated.

15  SECTION 3.      NEW LAW  A new section of law to be codified

16 in the Oklahoma Statutes as Section 7142 of Title 36, unless there

17 is created a duplication in numbering, reads as follows:

18  A. All carriers offering dental benefit plans shall file group

19 product base rates and any changes to group rating factors that are

20 to be effective on January 1 of each year, on or before July 1 of

21 the preceding year.

22  B. A dental benefit plan or the dental portion of a health

23 benefit plan that issues, sells, renews, or offers a specialized

24 health benefit plan contract covering dental services shall not

    Req. No. 11307                                                  Page 6
1 establish rates for any dental coverage plan issued to any

2 policyholder that are excessive, inadequate, or unfairly

3 discriminatory. To assure compliance with the requirements of this

4 section that rates are not excessive in relation to benefits, the

5 Insurance Commissioner shall promulgate rules to require rate

6 filings and shall require the submission of adequate documentation

7 and supporting information, including actuarial opinions or

8 certifications that the rates proposed by dental plans result in the

9 MLR meeting or exceeding the ratios described in subsection A of

10 Section 2 of this act.

11  C. 1. If a carrier files a base rate change and the

12 administrative expense loading component, not including taxes and

13 assessments, increases by more than the most recent calendar year's

14 percentage increase in the dental services Consumer Price Index for

15 All Urban Consumers, U.S. city average, not seasonally adjusted, the

16 base rate shall be deemed excessive and presumptively disapproved.

17  2. If the carrier's rate is presumptively disapproved:

18  a. the carrier shall communicate to all employers and

19  individuals covered under a group product that the

20  proposed increase has been presumptively disapproved

21  and is subject to a hearing by the Department, and

22  b. the Insurance Department shall conduct a public

23  hearing and shall properly advertise the hearing in

24  compliance with public hearing requirements.

    Req. No. 11307                                               Page 7
1   D. The carrier shall submit expected rate increases to the

2 Commissioner at least sixty (60) days prior to the proposed

3 implementation of the rates. If the Commissioner does not approve

4 or disapprove the rate filings within a sixty-day period, the

5 carrier may implement and reasonably rely upon the rates provided,

6 and the Commissioner may require correction of any deficiencies in

7 the rate filing upon later review if the rate the carrier charged is

8 excessive, inadequate, or unfairly discriminatory. A prospective

9 rate adjustment or rebate as described in Section 2 of this act are

10 the sole remedies for rate deficiencies. If the Commissioner finds

11 deficiencies in the rate filing after a sixty-day period, the

12 Commissioner shall provide notice to the carrier, and the carrier

13 shall correct the rate on a prospective basis.

14  SECTION 4.      NEW LAW  A new section of law to be codified

15 in the Oklahoma Statutes as Section 7143 of Title 36, unless there

16 is created a duplication in numbering, reads as follows:

17  A. Beginning July 1, 2026, and on or before July 1 of each year

18 thereafter, each dental insurer doing business in this state shall

19 file with the Insurance Department, in the form and manner

20 prescribed by the Department, an annual report on the dental loss

21 ratio for the preceding calendar year. The dental loss ratio annual

22 report shall include the following:

23  1. A combined dental loss ratio percentage for all individual

24 dental policies; and

    Req. No. 11307                                                Page 8
1   2. A combined dental loss ratio percentage for all group dental

2 policies issued to fully insured groups.

3   B. Not later than August 1 of each year, the Department shall

4 post the reported dental loss ratios for each dental insurer on a

5 publicly available website in a manner that is easily located and

6 identifiable to the public. The Department may not post the

7 underlying claims, premiums and other data used to calculate the

8 dental loss ratios and shall treat all claims, premiums, and other

9 data as confidential.

10  SECTION 5.      AMENDATORY       36 O.S. 2021, Section 7301, is

11 amended to read as follows:

12  Section 7301. A. No contract between a dental plan of a health

13 benefit plan and a dentist for the provision of services to patients

14 may require that a dentist provide services to its subscribers at a

15 fee set by the health benefit plan unless the services are covered

16 services under the applicable subscriber agreement.

17  B. As used in this section:

18  1. "Covered services" means services reimbursable reimbursed

19 under the applicable subscriber agreement, subject notwithstanding,

20 and without regard to the contractual limitations on subscriber

21 benefits as may apply, including, for example, deductibles, waiting

22 period or frequency limitations;

23  2. "Dental plan" means and shall include any policy of

24 insurance which is issued by a health benefit plan which provides

    Req. No. 11307                                                  Page 9
1 for coverage of dental services not in connection with a medical

2 plan; and

3   3. "Health benefit plan" means any plan or arrangement as

4 defined in subsection C of Section 6060.4 of this title or any

5 dental service corporation authorized pursuant to Section 2671 of

6 this title.

7   C. A health benefit plan or dental plan shall establish and

8 maintain appeal procedures for any claim by a dentist or a

9 subscriber that is denied based on lack of medical necessity. Any

10 such denial shall be based upon a determination by a dentist who

11 holds a nonrestricted license in the United States. Any written

12 communication to a dentist that includes or pertains to a denial of

13 benefits for all or part of a claim on the basis of a lack of

14 medical necessity shall include the identifier and license number

15 together with state of issuance, and a contact telephone number of

16 the licensed dentist making the adverse determination. The dentist

17 who reviewed the claim shall only be contacted at the telephone

18 number provided in the written communication about the denial during

19 business hours.

20  SECTION 6. This act shall become effective January 1, 2026.

21

22  60-1-11307      TJ  01/15/25

23

24

    Req. No. 11307                                                Page 10
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