Bill > SB1942

This bill modifies the definition of "covered services" within Oklahoma's dental insurance laws, specifically concerning dental plan fee regulations. Previously, "covered services" were defined as those reimbursable under a subscriber agreement, but this definition was subject to contractual limitations like deductibles or waiting periods. The bill amends this to clarify that "covered services" are those reimbursed under the agreement, *notwithstanding and without regard* to these contractual limitations. This change aims to provide a clearer understanding of what services are considered covered by dental plans, potentially impacting how claims are processed and fees are set. The bill also specifies that a "dental plan" includes insurance policies for dental services not connected to a medical plan, and a "health benefit plan" refers to defined entities under state law. Additionally, it mandates that health benefit plans and dental plans must have appeal procedures for claims denied due to lack of medical necessity, requiring that such denials be made by a licensed dentist and that written communications about denials include the reviewer's identification and contact information. This legislation is set to become effective on November 1, 2026.

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http://www.oklegislature.gov/BillInfo.aspx?Bill=sb1942&Session=2600