An Assembly bill introduced this week aims to apply medical-loss ratios for health insurers to dental care.
AB 1962 by Assembly member Nancy Skinner (D-Berkeley) would require dental health insurers to spend at least 80% of collected premiums on actual dental care.
The percentage rises to at least 85% of premiums for employees covered by plans through companies with 50 or more employees.
Health insurance companies already have those minimum loss ratios in place for health care services, but dental insurers do not face the same requirement. The idea is to make sure consumers get a fair deal, advocates said.
“Thanks to the Affordable Care Act, health insurers have to spend more patient dollars to cover medical care rather than overhead,” Skinner said in a written statement. “Dental insurers should do the same. [This bill] will ensure dental plans have similar limits on overhead, so more funding is available for dental care.”
If the medical-loss ratio dips below that percentage, health care insurers are required to send rebates to enrollees. Under the new bill, that requirement would apply to dental insurers.
The California Dental Association published a report last month that shows wide variation in care-to-overhead ratios among California dental insurers.
The bill heads first to the Assembly Committee on Health.
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