DENTAL BENEFIT PLAN W/O FEE S.B. 1106:
SUMMARY OF INTRODUCED BILL
IN COMMITTEE
Senate Bill 1106 (as introduced 11-13-24)
Committee: Finance, Insurance, and Consumer Protection
CONTENT
The bill would amend the Insurance Code to require a health plan or nonprofit dental care organization that provided dental benefits to have at least one method of payment or reimbursement that provided the dentist or dental therapist with 100% of the amount payable and did not include a fee for the payment or reimbursement.
"Health plan" would mean all the following:
-- An insurer providing benefits under a health insurance policy, including a policy, certificate, or contract that provides coverage for specific diseases or accidents only, an expense-incurred vision or dental policy, or a hospital indemnity, Medicare supplement, long-term care, or one-time limited duration policy or certificate, but not to payments made to an administrative service only or cost-plus arrangement.
-- A multiple employer welfare arrangement regulated under Chapter 70 (Multiple Employer Welfare Arrangements) that provides hospital, medical, surgical, vision, dental, and sick care benefits.[1]
The bill would require a health plan or nonprofit dental care organization operating under Public Act 125 of 1963 that provided dental benefits to provide the dentist or dental therapist with 100% of the amount payable and could not require the dentist or dental therapist to incur a fee to access payment or reimbursement.
(Public Act 125 of 1963 provides for the incorporation, supervision, and regulation of nonprofit dental care organizations.)
The bill would not apply to a fee imposed by the dentist's or dental therapist's financial institution.
If the dentist or dental therapist opted out of a method of payment described above, the decision would remain in effect until the dentist or dental therapist opted back into the prior payment plan or a new plan contract was executed.
FISCAL IMPACT
The bill would have no fiscal impact on State or local government.
This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.