Bill > HB439

This bill creates new regulations for dental plans in Missouri by establishing requirements for dental loss ratio reporting and rebates. The bill defines "dental loss ratio" as the percentage of premiums spent on patient care versus administrative costs, calculated through a specific formula that excludes various administrative expenses like infrastructure costs, personnel expenses, and certain vendor payments. A "dental plan" is defined as any health benefit plan covering dental services, excluding state-sponsored health insurance programs. Dental plans will be required to file an annual dental loss ratio report with the Department of Commerce and Insurance before March 1st each year, detailing their expenses and premiums from the previous calendar year. If a dental plan's loss ratio is less than 85%, they must provide an annual rebate to enrollees, with the rebate amount calculated based on the excess revenue spent on overhead or administrative costs. The bill also stipulates that failure to provide the required rebate by a dental plan could be considered an unlawful practice under existing consumer protection laws. The goal of this legislation appears to be increasing transparency and ensuring that dental plans spend a substantial portion of their premiums on actual patient care.

https://house.mo.gov/Bill.aspx?bill=HB439&year=2025&code=R