Bill > S505

This bill aims to regulate the medical loss ratio (MLR) for insurance corporations offering dental benefit plans in Massachusetts. The key provisions of the bill include: 1. Requiring insurance carriers to submit detailed financial information on their dental benefit plans, including current and projected MLRs, administrative expenses, and other financial data. The Commissioner of Insurance is empowered to review and approve or disapprove proposed rate changes based on this information. 2. Establishing an 80% MLR requirement for dental benefit plans starting from January 1, 2019 onwards. If a carrier's MLR falls below this threshold, they must issue refunds to their covered individuals and groups. 3. Mandating public hearings and oversight measures, including the ability for the Attorney General to intervene, when a carrier's proposed rate increase is presumptively disapproved by the Commissioner. 4. Requiring carriers to submit comprehensive annual financial statements to the Division of Insurance, which will then be made public and shared with the Center for Health Information and Analysis for further review and analysis. The overall aim of the bill is to increase transparency and accountability in the dental insurance market, while also ensuring that a minimum percentage of premium dollars are spent on actual dental care services rather than administrative costs and profits.

Business and Industry

https://malegislature.gov/Bills/190/S505