The bill amends the "Unfair Claims Settlement Practices Act" to introduce specific provisions addressing unfair practices related to dental insurance claims. It establishes that it is an unfair claims practice for a dental insurer to refuse to honor a direction to pay executed by an insured or claimant for dental services, regardless of whether the dental service provider is contracted with the insurer, provided that the dental service provider meets the insurer's credentialing criteria and has not been previously terminated as a participating provider.

The bill prohibits insurers from modifying the amount of benefits paid directly to the dental service provider compared to what is paid to the majority of participating providers. Insurers are also required to inform dental service providers of alternative payment methods and cannot mandate that payments be accepted only via virtual credit card.

Additionally, the bill allows insurers to review the records of the dental service provider to confirm that services were rendered, while ensuring that the insurer cannot reduce the benefits paid. The act aims to enhance consumer protection in the dental insurance sector and will take effect upon passage.

Statutes affected:
2461: 27-9.1-4