Bill > SB433

This bill, known as the "Dental Insurance Transparency Act," introduces comprehensive regulations for dental health care service plans in West Virginia. The bill requires dental carriers to file annual Medical Loss Ratio (MLR) reports with the Insurance Commissioner, detailing how much of their premium revenue is spent on patient care versus administrative costs. For large group plans, at least 85% of premiums must go toward patient care, while individual and small group plans must spend at least 80%. If carriers do not meet these MLR thresholds, they must provide enrollees with an annual rebate in the form of a premium reduction. The bill also establishes new rules for payment methods, allowing dental carriers to use credit cards or electronic funds transfers for reimbursements only if providers are notified in advance and offered alternative payment options. Additionally, the legislation introduces guidelines for third-party network contracts, ensuring that dental care providers have the right to choose whether their services and discounted rates can be accessed by third parties, and requiring carriers to maintain transparency about these network arrangements. The Insurance Commissioner is authorized to propose rules and emergency regulations to implement these provisions, with the overarching goal of increasing transparency and protecting the interests of dental care providers and patients.

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http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=433&year=2025&sessiontype=RS&btype=bill