The proposed bill aims to establish the "Dental Insurance Transparency Act" in West Virginia, which introduces regulations for dental health care service plans. It mandates that dental carriers provide transparency regarding the expenditures of patient premiums by requiring them to file annual medical loss ratio (MLR) reports with the Insurance Commissioner. These reports must detail the percentage of premium funds spent on patient care versus administrative costs, and if the spending falls below a specified threshold, carriers are obligated to issue rebates to enrollees in the form of premium reductions. The bill also outlines definitions for key terms, such as "dental carrier," "provider," and "medical loss ratio," and sets minimum MLR requirements based on the number of enrollees.

Additionally, the bill authorizes various methods of payment for dental services, including credit card and electronic funds transfer, while ensuring that providers are informed of any associated fees. It allows dental carriers to enter into third-party network contracts under specific conditions, ensuring that providers maintain control over their services and rates. The legislation also includes provisions for rulemaking by the commissioner to implement these regulations effectively. Overall, the bill seeks to enhance transparency and accountability in dental insurance practices, ultimately benefiting consumers by ensuring that a greater portion of their premiums is directed towards patient care.

Statutes affected:
Introduced Version: 33-64-1, 33-64-2, 33-64-3, 33-64-4, 33-64-5, 33-64-6, 33-64-7