The NADP Government Relations Workgroup continues to monitor, analyze, and advocate on state legislation and regulations on behalf of the industry. The group’s main focus is currently on active legislation in New Jersey, as well as several regulatory issues in other states:
NJ A4538 – This bill would require dental carriers to issue premium credits to policyholders in an amount equal to the value of reduced claims experience for the period of March 27 to May 26. The bill exempts any carrier that has already issued a credit to policyholders in an amount of more than 50% of one month’s premium for each policyholder during the period of March through June 2020. There is also an exemption for any carrier deemed by the Department of Insurance (DOI) as having taken sufficient action to remove them from the bill’s applicability. NADP submitted comments in opposition. NADP has also retained a lobbying firm to assist with advocacy on this bill.
NJ S2853 – This bill, sponsored by the state dental association, would prohibit a carrier from including in its provider contracts a provision that: 1) allows the carrier to deny payment to a dentist for a covered service/procedure, and 2) prohibits the dentist from collecting the amount owed for that service/procedure from the covered person. NADP submitted comments in opposition. NADP’s lobbying firm is also assisting with advocacy on this bill.
CA DOI Notice – The California DOI has published a notice requesting all health insurance companies to provide policy holders with partial premium refunds. This request also includes other options for compliance, for example: dental plans with annual maximums can satisfy the request by increasing their annual maximums for 2021. The notice also asks insurers to report to the DOI within 45 days all actions taken and/or contemplated in response to the notice. CADP has discussed the notice and conducted outreach to the DOI on questions raised by members.
NM Draft Rule – Officials from New Mexico’s Office of Superintendent of Insurance (OSI) have informally shared a draft rule concerning minimum standards for limited scope dental and vision plans. NADP has provided feedback on the draft rule and requested the OSI to hold a workshop with carriers to further discuss relevant issues.
NCOIL Model Act
The National Council of Insurance Legislators held a meeting to discuss the proposed Model Act sponsored by the American Dental Association. The proposal has been amended to strike provisions related to minimum loss ratios and retroactive denials; the remaining sections deal with network leasing, prior authorizations, and virtual credit card payments. NADP, America’s Health Insurance Plans (AHIP), and American Council of Life Insurers (ACLI) appeared at the meeting to testify on the amended proposal. It is likely that the proposal will continue to evolve before the next NCOIL meeting, which is scheduled for Dec. 10.
With questions on any of the issues described above please contact Associate Director of Government Relations Artur Bagyants.