The proposed bill aims to reform the dental insurance system in Washington by prohibiting unfair and deceptive practices, thereby enhancing patient choice and access to care. It highlights the need for a system that prioritizes patients and dental professionals over corporate interests, ensuring that patients can select their dentists and receive the full benefits of their insurance without restrictive corporate limitations. Key provisions include mandating that a certain percentage of premium dollars be allocated directly to patient care, allowing patients to request independent reviews of denied claims, and ensuring that dental insurers cannot deny coverage based on independent diagnoses or same-day procedures.

Additionally, the bill introduces several new sections to existing laws, including requirements for limited health care service contractors to allow dentists to make treatment decisions in consultation with patients, and mandates that dental insurers provide transparent information regarding payment methods and administrative expenses. It also establishes a framework for monitoring dental loss ratios and requires insurers to refund excess premiums if their loss ratios fall below 85%. The bill seeks to create a more equitable and transparent dental insurance market, ultimately improving access to care and reducing out-of-pocket costs for Washington residents.

Statutes affected:
Original Bill: 48.44.035, 48.44.495, 48.43.743