This bill aims to enhance transparency and accountability in dental health care service plans in West Virginia by introducing a new article to the Code of West Virginia. It establishes definitions for key terms related to dental insurance, mandates that carriers file annual reports on their medical loss ratios (MLR), and requires that a minimum of 85% of premium revenue be spent on patient care. The bill also prohibits dental carriers from imposing restrictions on payment methods to providers and ensures that any contractual clauses that conflict with these provisions are void. Additionally, it allows for the establishment of third-party network contracts while setting standards for their operation.

Furthermore, the bill stipulates that if a dental carrier fails to meet the required MLR, it must provide annual rebates to enrollees in the form of premium reductions. The Insurance Commissioner is tasked with enforcing these regulations and may propose rules to implement the provisions of the bill. Overall, the legislation seeks to protect consumers by ensuring that a significant portion of their premium payments is directed towards actual dental care rather than administrative costs.

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