Bill > HB1481

This bill introduces new regulations for dental insurers in North Dakota, focusing on rate approval and transparency. The first section establishes that the insurance commissioner can disapprove a dental insurer's proposed rate increase if administrative expenses grow by more than 4%, reported surplus contributions exceed 2% of total revenue, or the dental loss ratio (the percentage of premium dollars spent on patient care) falls below 75%. If an insurer's dental loss ratio is less than 75%, they must refund excess premiums to covered individuals and groups, providing either a direct refund or a credit on future premiums. The bill precisely defines how the dental loss ratio is calculated, specifying what counts as patient care expenses and what does not, such as excluding administrative costs, broker payments, and non-clinical service fees. The second section requires dental insurers to file an annual report with the insurance commissioner by April 30th, detailing their dental loss ratio information, which will be made publicly available on the department's website to allow comparison between insurers. The bill becomes effective on July 1, 2027, and applies to dental insurers with more than 1,000 enrollees, with provisions for the commissioner to waive refund requirements if they determine it would financially impair the insurer.