Rhode Island’s More for Your Smile legislation protects patients by increasing transparency and accountability for dental insurance companies, while ensuring patient premiums go to patient care.
Right now, Rhode Island lawmakers are considering legislation that will require dental insurance companies to spend at least eighty-three percent (83%) of premiums on dental benefits and quality improvements instead of executive compensation, corporate profits, bonuses, and administrative expenses.
Join us in telling lawmakers, Rhode Island patients deserve more transparency, more value, and more access to oral health care.
Better Dental Benefits Urgently Needed
More than 1 in 2 Americans report skipping care or avoiding it all together because of costs, and the most frequently skipped form is dental work. Dentists care about their patients and oppose any practice – like padding insurers’ bottom line – that limit patients’ access to the care they need.
As much as forty percent (40%) of patient premium dollars go to executive compensation, corporate profits, bonuses, and administrative expenses, instead of being directed toward patient care.
The Rhode Island Dental Association supports the following dental insurance reforms that achieve more for patients.
Direct Patient Dollars to Patient Care
Requires Insurance to Disclose Where Fees Go
Reduce Patient Out-of-Pocket Costs
Want to Make a Difference?
GET IN TOUCH
Contact your legislator today and tell them you want More for Your Smile and urge them to support House Bill H5497 and Senate Bill S0286.
Join us in letting your legislators know that delivering more transparency, more accountability, and more value for dental insurance is essential to the oral health and well-being of Rhode Island working families.
Pass More for Your Smile
When you speak to your elected official, tell them:
- Dental insurance is difficult to navigate and hardly covers necessary services, meanwhile, dental insurance executives’ compensation and profits keep going up.
- As much as 40% of your premium dollars go toward things like executive compensation, corporate profits, bonuses, and administrative expenses, when it should be going toward patients’ crucial oral health care.
- No one should have to delay treatment because their insurance prioritizes profits over their health and well-being.
- The Rhode Island Dental Association has legislation that will deliver more accessibility, more transparency, and more value for dental insurance.
- Please tell your elected officials to pass the Rhode Island Dental Association’s More for Your Smile legislation, which includes House Bill H5497 and Senate Bill S0286.
UNDERSTANDING MEDICAL LOSS RATIO
Why do dentists care about Medical Loss Ratio (MLR)?
Patients rightfully expect their dental insurance premiums to be used to support their oral health, and patients deserve visibility into how much of their premiums are paying for care as opposed to dental insurer administrative costs. Dentists care about their patients, and it is unfair that their money is being spent on executive compensation, bonuses, corporate profits, and administrative expenses rather than paying for actual patient care.
What is Medical Loss Ratio? Why does it exist?
Mental Loss Ratios, or MLRs, set a minimum amount that insurers must spend on actual healthcare services in support of patient care. MLRs were established at the national level for health insurers by the Affordable Care Act: Federal law requires medical insurance plans to minimally operate at an 85% MLR for larger carriers and 80% MLR for smaller carriers. In most states, dental insurers are not held to any such standard.
How will patients benefit from establishing a Medical Loss Ratio?
Ensuring transparency and value in dental insurance rates will help reduce out-of-pocket costs for dental patients, which will make access to dental care and procedures more affordable and encourage people who are reluctant to go to the dentist to receive dental care.
How was it determined that the MLR for dental plans should be at 83% and not some other number?
It’s within the same range the Affordable Care Act (ACA) mandated, which has worked for years.
Why does medical insurance have a requirement, but dental insurance does not?
The ACA includes a host of positive reforms for patients, including a Loss Ratio for major medical health plans. Because of a quirk in how dental plans are sold, largely as stand-alone dental plans separate from medical coverage, the plans do not have to abide by consumer protections like loss ratios. That said, it is certainly time to bring this important consumer protection reform that has helped consumers receive quality, accessible and more affordable care on the medical side to dental insurance as well.
What happened when the ACA imposed MLR on medical insurance companies?
The regulation of insurers’ Medical Loss Ratios is one of the most significant consumer protections in the ACA that took effect in 2011. This provision helps protect consumers from overpriced health plans and offers rebates when insurers do not deliver the required percentage of care as determined by the MLR in the state. Kaiser Family Foundation estimates that insurers will issue a total of about $1 billion in MLR rebates across all commercial markets in the U.S. in 2022. That’s 8.2 million people in the U.S. who will be owed a rebate from their medical insurers that did not spend enough on healthcare coverage.
How will this legislation increase accountability and transparency in dental insurance?
Standardizing dental loss ratio will increase transparency and accountability in dental insurance by requiring dental insurance carriers to disclose administrative costs and other financial information annually.
About the Rhode Island Dental Association
The Rhode Island Dental Association (RIDA) is a professional organization of Rhode Island dentists dedicated to the service of the public and advancement of the profession through education, advocacy, and member services. We serve as our members’ main source of information on oral health in Rhode Island. RIDA members have access to local, state and federal political advocacy, Continuing Education, marketing services, and more.
The RIDA is also an invaluable resource for the general public. Whether you are looking for a dentist close to you, want to learn the latest on oral health, or have questions about oral health, the Rhode Island Dental Association is here to help you.
Members of the RIDA have made a special commitment to uphold the ethical code, practice standards, and the mission of RIDA: to improve the dental health of the public and to promote the art and science of dentistry.