Bill > SB1596

This bill establishes new regulations for dental insurance plans in Missouri, primarily focusing on a "dental loss ratio" (DLR), which is the percentage of premiums a dental plan spends on actual patient care versus administrative costs. The bill defines DLR by specifying what counts as patient care expenses (numerator) and what counts as earned premiums (denominator), excluding taxes, regulatory fees, and certain other payments. A "dental plan" is defined as any plan offering dental coverage, with exceptions for state-sponsored programs like MO HealthNet. Dental plans will be required to file an annual DLR report with the Department of Commerce and Insurance, similar to a federal reporting form, by March 1st each year. The department will have 90 days to review these reports, and all submitted data will be made public. Crucially, if a dental plan's DLR falls below 85%, it must provide an annual rebate to its enrollees by August 1st of the following year, with the rebate amount being the excess revenue spent on administrative costs. Failure to provide these rebates will be considered an unlawful practice.

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https://www.senate.mo.gov/26info/BTS_Web/Bill.aspx?SessionType=R&BillID=2581462