Higher costs, lower access: Proposed dental MLR requirements could disrupt care and hurt consumers. See why CHBRP warns against this policy!
The California Assembly Committee on Health requested that the California Health Benefits Review Program (CHBRP)conduct an abbreviated analysis of California Assembly Bill (AB) 2028. AB 2028 would require a health care service plan or health insurer that issues, sells, renews, or offers a specialized dental health care service plan contract or specialized dental health insurance policy to comply with a (dental) medical loss ratio (MLR) of 85% and to provide a specified rebate to an enrollee or insured if the minimum MLR is not met. The bill, as written, would require dental MLRs to be calculated each year. The bill’s 85% dental MLR would apply to both the Department of Managed Health Care (DMHC)- and California Department of Insurance (CDI)-regulated dental plans and policies, in the individual, small-group, and large-group markets.2 The bill excludes the Medi-Cal program. [READ FULL REPORT]
Join Mike Adelberg, Executive Director of the National Association of Dental Plans (NADP), as he sits down with Garen Corbett, Director of the California Health Benefits Review Program (CHBRP), for an insightful discussion on the impact of medical loss ratio (MLR) regulations on dental insurance.
Key Discussion Points:
- Understanding CHBRP’s Role – A unique bridge between academic research and legislative decision-making.
- Assembly Bill 1048 & Dental MLR – Why the proposed 85% dental MLR mandate in California faced major hurdles.
- Projected Premium Increases – The study revealed potential 44% hikes for PPOs and 166% for HMOs, sparking concerns over affordability and market stability.
- Why Dental is Different – Insights into how dental insurance differs from medical insurance and why a one-size-fits-all MLR model may not work.
- Legislative & National Impact – What other states can learn from California’s experience and how policymakers can use data-driven insights for decision-making.
📌 Watch this deep dive into healthcare policy, dental benefits, and the potential ripple effects of MLR regulations below.
The passage of the 2022 ballot referendum (Question 2) in Massachusetts established a minimum loss ratio for dental plans based on the loss ratio of medical plans, which earn 20x the premium. Since then, many states have considered legislation related to reporting or establishing loss ratios for limited-scope dental plans.