This bill amends existing laws regarding dental insurance assignment of benefits under various insurance chapters, specifically Chapters 27-18, 27-19, and 27-41. It allows insured individuals to direct, in writing, that their dental benefits and corresponding reimbursements for covered services be paid directly to any dental care provider, regardless of whether the provider has contracted with the insurance entity.

Upon receipt of a duly executed written direction to pay and written notice thereof, the insurance entity is required to pay the benefits directly to the dental care provider. The amount of benefits paid must be no less than the highest reimbursement amount actually paid to any participating provider for the same covered dental service, as listed in the entity's benefit allowance tables or fee schedules.

The bill also prohibits insurance entities from using tiered reimbursement structures, geographic modifiers, or network classifications to reduce the benchmark amount for payments. Additionally, it ensures that the benefit amount cannot be reduced, modified, or conditioned based on the provider's non-participation. The act is set to take effect on January 1, 2027, and aims to clarify the payment process for dental insurance benefits.

Statutes affected:
7722: 27-18-63, 27-19-54, 27-41-66