Bill > S4063

This bill, called the "Transparency for Dental Health Care Costs Act," requires dental insurance carriers in New Jersey to submit an annual detailed report on their dental loss ratio (the percentage of premium dollars spent on patient care) to the Commissioner of Banking and Insurance. The report must include the number of covered persons, plan cost-sharing and deductible amounts, annual coverage limits, and follow the federal Medical Loss Ratio Annual Reporting Form. The commissioner will then calculate an average dental loss ratio for each market segment using three years of data and identify carriers with loss ratios that fall outside one standard deviation of the average. If a carrier consistently reports a low dental loss ratio, the commissioner may investigate and take enforcement actions, including requiring the carrier to rebate premiums to policyholders. The bill aims to increase transparency in dental insurance pricing and ensure that a reasonable portion of premium dollars are spent on actual dental care. The reporting requirements will be made publicly available through the department's website or an all-payer health claims database, allowing consumers to compare dental insurance plans. The bill will take effect three months after enactment and apply to all new and renewed dental insurance policies during that time.

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https://www.njleg.state.nj.us/bill-search/2024/S4063