Bill > SB548

This bill aims to increase transparency in dental health care insurance products by requiring dental carriers, which are entities providing dental benefits, to annually report their Medical Loss Ratio (MLR) to the Insurance Commissioner. The MLR is the percentage of premiums spent on patient care versus administrative costs. If a carrier's MLR falls below 85%, they must provide an annual rebate to enrollees, typically as a premium reduction. The bill also establishes standards for how dental carriers can pay dental providers, prohibiting exclusive reliance on fee-generating methods like credit cards and requiring clear consent from providers for alternative payment methods. Furthermore, it authorizes and sets rules for third-party networks, which are entities that contract with dental carriers to access provider networks, ensuring providers are informed about and consent to such arrangements and that these third parties adhere to the original provider network contract terms. The bill also grants the Commissioner the authority to create rules to implement these provisions.

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http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=548&year=2026&sessiontype=RS&btype=bill