Bill Text - SB749 (2020)

Relative to non-covered services under dental insurance plans.


Revision: Feb. 19, 2020, 9:49 a.m.

SB 749  - AS INTRODUCED

 

 

2020 SESSION

20-3127

01/04

 

SENATE BILL 749

 

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

 

SPONSORS: Sen. Rosenwald, Dist 13; Sen. Bradley, Dist 3; Sen. Soucy, Dist 18; Rep. Van Houten, Hills. 45; Rep. Indruk, Hills. 34

 

COMMITTEE: Commerce

 

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ANALYSIS

 

This bill makes it an unfair insurance trade practice for an insurance entity regulated by the insurance department that covers dental services to require a participating dentist to 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.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

20-3127

01/04

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty

 

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; Unfair Insurance Trade Practices; Non-Covered Services Under Dental Insurance Plans.  Amend RSA 417:4 by inserting after paragraph XXIII the following new paragraph:

XXIV.  Non-Covered Dental Services.

(a)  No insurer, health care service contractor, health maintenance organization, dental insurer, or any other similar entity, including Delta Dental Plan of New Hampshire Inc., subject to regulation by the insurance department that covers dental services, 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 service for which reimbursement is available under an enrollee's plan contract, 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.

(d)  Fees for covered services shall be set in good faith and shall not be nominal.

2  Effective Date.  This act shall take effect January 1, 2021.