Bill Text - SB169 (2013)

Relative to non-covered services under dental insurance plans.


Revision: Feb. 4, 2013, midnight

SB 169 – AS INTRODUCED

2013 SESSION

13-1003

01/10

SENATE BILL 169

AN ACT relative to non-covered services under dental insurance plans.

SPONSORS: Sen. Sanborn, Dist 9; Sen. Rausch, Dist 19; Sen. Soucy, Dist 18; Rep. Hammond, Hills 24

COMMITTEE: Commerce

ANALYSIS

This bill declares that no insurer offering a dental plan shall require a participating dentist to provide services to an enrolled participant at a fee set by the insurer unless such dental services are covered services.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

13-1003

01/10

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Thirteen

AN ACT relative to non-covered services under dental insurance plans.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Paragraph; Non-Covered Dental Services. Amend RSA 417:4 by inserting after paragraph XXIII the following new paragraph:

XXIV.(a) No insurer that covers dental services, including Delta Dental Plan of New Hampshire, Inc., and no contract or participating provider agreement with a dentist shall require, directly or indirectly, that a dentist who is a participating provider provide services to an enrolled participant at a fee set by, or at a fee subject to the approval of, the regulated entity unless the dental services are covered services.

(b) No person providing third party administrator services shall make available for any customers a plan that sets dental fees for providers in its provider network for any services except covered services.

(c) In this paragraph “covered services” means dental care services for which reimbursement is available under an enrollee’s plan contract at a benefit level of at least 50 percent, or for which reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation.

2 Effective Date. This act shall take effect January 1, 2014.