The National Council of Insurance Legislators (NCOIL) recently adopted a model bill addressing dental loss ratios. The measure, which was a negotiated package between the ADA and the National Association of Dental Plans, is largely modeled off of a Colorado bill enacted in 2023.
The NCOIL model requires dental insurers to disclose their plans’ loss ratios – or the amount spent on patient care, claim payments and quality improvement (as opposed to non-patient care, such as administrative costs, salaries and other operational expenses). If adopted in a state, state insurance departments would be empowered under the model to address any dental plans more than one standard deviation away from the average DLR for all plans.
States still must introduce and adopt the language through their own legislative processes to take effect, but NCOIL model bills tend to be more widely adopted. For example, the widespread adoption of legislation addressing non-covered services first started as an NCOIL model bill.
AAOMS has been supportive of the ADA’s efforts throughout this process and applauds the development of this important model.
