Bill > SB81

This bill establishes a minimum medical loss ratio (MLR) for dental benefit plans in Alabama, meaning that insurers must spend a certain percentage of the premiums they collect on actual dental care services for patients. Specifically, stand-alone individual dental plans must have an MLR of at least 75 percent, while stand-alone group dental plans must have an MLR of at least 83 percent. The bill defines "dental benefit plan" as an underwritten, stand-alone individual or group plan that covers dental care services, excluding self-funded plans and certain government-sponsored or grandfathered health plans. It also clarifies how the "dental loss ratio" is calculated, which involves the total claims paid for dental care services minus recoveries, divided by the total premiums collected minus taxes and regulatory fees. Insurers are required to report their MLR annually to the Commissioner of Insurance, and if the ratio falls below the required percentage, they must refund the excess premium collected to policyholders or groups as a rebate. The bill also makes conforming changes to existing laws related to corporations organized under specific articles and health maintenance organizations to include this new MLR requirement, and it is set to become effective on October 1, 2026.

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