BALLOT QUESTION – 2022
APPLY A “MEDICAL LOSS RATIO” TO DENTAL INSURANCE
SHOULD DENTAL INSURANCE PLANS HAVE A PROFIT LIMIT
LIKE MEDICAL INSURANCE PLANS ALREADY HAVE?
vote yes for better dental coverage
MEDICAL insurance plans must pay out 88% of their revenue to cover patient care. This is good!
DENTAL insurance plans have no payout requirement. This is bad!
- vote YES! – If you want more value for your DENTAL insurance dollar.
- vote YES! – If you want your DENTAL Insurance to pay the same standard as your MEDICAL insurance.
- vote YES! – If you want proper coverage for elderly parents, for your family, or for you.
Initiative of the
Committee on Dental Insurance Quality
SUMMARY OF PROPOSED LAW
The proposed law will impose a profit limit, known as a medical loss ratio, on dental insurance plans that is similar to the already existing profit limits on medical insurance plans.
The proposed law will ensure that at least 83% of insurance premiums received by dental insurance carriers is directed towards dental patient claims or improvements in patient quality of care.
If less than 83% is paid out by the dental insurance carrier for patient care, the excess premium payments will be refunded to you and not retained as excess profit.
This proposed law would take effect on January 1, 2024, and your quality of dental care will immediately improve.
HISTORY OF PROPOSED LAW
The Medical Loss Ratio (MLR) law currently forces all medical insurance companies in the state to pay out at least 88% of their accumulated premium revenue for patient medical claims or improvements in patient quality of care. This leaves 12% to cover all other costs and profits of the medical insurance company. If a medical insurance plan fails to pay out the required 88% of its accumulated premiums, the insurance company must annually rebate the difference proportionally to its members.
The medical loss ratio (MLR) was introduced nationwide by the Affordable Care Act of 2010. A medical loss ratio forces a medical insurance company to either lower its premiums or pay more in claims. It protects insured members from excessive costs and unfair denials of coverage. In 2011 alone, this law forced medical insurance companies to pay back 1.1 billion dollars in rebates to individuals and families (according to the National Association of Insurance Commissioners).
When the 2010 Affordable Care Act adopted the medical loss ratio, it did not include dental insurance companies. Government data from 2018 indicates that dental insurance companies vary in their profits, with many companies in the range of 50% profit. These high profits are accomplished by high premiums and low claims payouts. For this reason, consumers of dental insurance feel cheated out of their annual premiums.
Under the proposed law, consumers of dental insurance would receive greater return on their premium payments, because either their premium would decrease or their coverage would increase. Either way, the consumer would benefit, and the insurance company would have reduced profits, similar to that of medical insurance companies.
COMMITTEE MEMBERS
Dr. Robert Petrosino – Officer
Dr. Andrew Chase – Officer
Dr. Patricia Brown – Officer
Dr. Laura Rizkallah – Officer
Linda Gendall – Treasurer
John Gendall – Officer
Joanne Dempsey – Officer
Neill Kumar – Officer
Dayse Kumar – Officer