Bill > H0729

This bill, known as the Idaho Dental Plan Transparency Act, amends existing law to require dental health care service plans, which are entities providing dental coverage in exchange for premiums (excluding certain government programs like Medicaid and CHIP, short-term plans, and others), to annually report their Dental Loss Ratio (DLR) to the Idaho Department of Insurance. The DLR is a crucial metric that calculates the percentage of premium funds spent on actual patient care, potentially including community health initiatives, but excluding administrative overhead. The bill defines key terms like "earned premium" (money paid by enrollees for coverage) and "incurred claims" (claims related to services provided in a reporting year). Starting in 2027, these DLR reports, which must detail what was included in the calculation and the final ratio, are due by July 31st each year and will be reviewed and published by the Department by January 1st annually. The Department can request additional data verification within 30 days of the report's due date, and plans will have another 30 days to respond. The Department will then make this information, including aggregate DLRs and other reported data, publicly available on a searchable website by January 1st of the following year, allowing for comparisons between different dental plans. The DLR is calculated by dividing the amount spent on enrollee services (including clinical services, unpaid claim reserves, and oral health improvement activities) by the total earned premium revenue, excluding taxes and regulatory fees. This legislation is declared an emergency and will take effect on July 1, 2026.

Business and Industry

Health and Welfare Committee (House)

https://legislature.idaho.gov/sessioninfo/2026/legislation/H0729/