Bill > HB2805

This bill creates the Oklahoma Medical Loss Ratios for Dental (DLR) Health Care Services Plans Act, which establishes a comprehensive framework for regulating dental insurance plans in Oklahoma. The legislation defines key terms such as "dental carrier" and "dental loss ratio" (DLR), which calculates the percentage of premium dollars spent on patient care by dividing the amount spent on clinical dental services and quality improvement activities by total premium revenue. Dental carriers will be required to electronically file an annual report with the Insurance Commissioner by May 1st each year, detailing their dental loss ratios, enrollee information, and plan details. The Commissioner will publicly share this data, allowing consumers to compare dental loss ratios across different carriers. The bill also introduces a mechanism to identify and investigate carriers with dental loss ratios significantly below the market average, potentially requiring them to issue rebates to policyholders or face enforcement actions. Carriers consistently falling below the average may be subject to minimum loss ratio requirements and additional regulatory oversight. Importantly, the bill excludes certain plans like Medicaid, CHIP, and ERISA-covered employer-sponsored self-funded plans from its provisions. The act is set to become effective on November 1, 2025, giving insurers time to prepare for the new reporting and potential financial requirements.

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http://www.oklegislature.gov/BillInfo.aspx?Bill=hb2805&Session=2600