HB 2785
To provide for transparency of the expenditure of dental health care plan premiums
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Sign in to take action- Introduced
- Passed House of Delegates
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill, the "West Virginia Medical Loss Ratios for Dental (DLR) Health Care Services Plans Act," aims to increase transparency in how dental health care plan premiums are spent. It requires dental insurance carriers to file annual reports detailing their spending on patient care, including clinical services and quality improvement activities. If a carrier’s spending falls below a certain percentage of premium revenue (the ‘dental loss ratio’), they may be required to rebate a portion of the premiums back to patients. The bill also establishes a process for the Commissioner to identify outlier plans and potentially implement corrective actions.
Key provisions
- Requires dental insurance carriers to file annual ‘Dental Loss Ratio’ (DLR) reports.
- Establishes a minimum percentage of premium revenue that must be spent on patient care (the DLR).
- Mandates annual rebates to patients if the DLR falls below the required percentage.
- Defines key terms related to dental health care plans and loss ratios.
- Requires carriers to provide additional data in their annual reports, including enrollee numbers and plan cost-sharing details.
- Allows the Commissioner to investigate outlier plans and potentially order rebates.
- Establishes a process for the Commissioner to identify carriers that increase rates in excess of the Consumer Price Index.
- Requires the Commissioner to make DLR data publicly available.
Who is affected
- Dental insurance carriers
- Dental health care plan enrollees
- West Virginia residents with dental insurance
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