A dental insurance reform bill has been filed by Senator Heidi Seevers Gansert (R-Reno) to raise the requirement that insurance companies must spend on patient care. If passed, at least 80 percent of the money dental insurance companies collect from patients must be spent on dental care or patients get the difference back.
This change would match Nevada’s requirement of spending on medical care and will help improve and increase access to dental care in Nevada.
“Dental patients deserve the same consumer protections as medical patients,” added Sen. Seevers Gansert. “Empowering our Division of Insurance to ensure premiums are being spent on dental care in the proper ratio to improve outcomes will help Nevadans live healthier and happier lives.”
According to the “Scorecard on State Health System Performance”, Nevada currently ranks 48th in the nation for overall health care, 50th for access and affordability, 51st for prevention and treatment, 38th for avoidable hospital use and cost, and 39th for the healthiness of its residents.
The bill also requires insurance companies to submit financial statements reporting their use of patient premiums. If the insurance companies do not meet the 80 percent requirement, they must refund the difference to patients. In addition, the Nevada Insurance Commissioner shall approve proposed rates for dental insurance plans, to ensure that insurance companies do not unfairly raise premiums. The Nevada Division of Insurance will also publish a list of dental insurance companies that are in and out of compliance.
“Requiring dental insurers to file annual financial reports to disclose what percentage of premium dollars are spent on care protects patients,” added Dr. Jason Doucette, president of the Nevada Dental Association. “Without transparency regulations, dental patients often have to pick up the tab to cover the out-of-pocket costs and non-covered dental care expenses while dental insurance providers pocket the remainder of patient premium dollars.”
The bill is inspired by the overwhelming passage (72%) of ballot Question 2 by Massachusetts voters, which assures 83 percent of patient dollars are spent on patient care, protects consumers from large increases in dental insurance premiums, and provides increased transparency of and accountability for dental insurer spending. Connecticut and Oklahoma are also pursuing dental insurance reform similar to the Massachusetts ballot measure.
Nevada’s legislative session begins Feb. 6, 2023.