Legislative Deep Dive: Dental Insurance Transparency Bill (SB23-179)

Becky O'GuinFeatured News

By Jennifer Goodrum, CDA Lobbyist
From the Summer 2023 Journal of the Colorado Dental Association

The CDA’s priority bill for the 2023 legislative session, SB23-179, is now law. SB23-179 passed with a broad majority of legislative support. It was signed by Gov. Polis on June 2 and takes effect on Aug. 6. 

SB23-179 does several important things:

  • Defines a Dental Loss Ratio (DLR) data reporting framework;
  • Requires the state’s Division of Insurance (DOI) to clarify reporting forms and processes to ensure that data is consistently reported and comparable;
  • Requires dental plans to annually report data on what percent of premium dollars are spent by the plan on patient care;
  • Creates a public website where employers, patients and dentists can compare data from dental plans when making choices about plan selection and participation;
  • Creates an initial framework for accountability and enforcement of outlier dental plans who spend far too little of premiums on patient care, and lays the groundwork for future conversations on accountability structures; and
  • Requires a clear and consistent notation on all dental insurance cards that shows whether or not the plan is regulated by the state of Colorado – and subject to state laws like the DLR reporting, noncovered services provisions, timely payment of claims laws, etc.

A special shoutout goes to the four incredible bill sponsors who were instrumental in shepherding this bill through the legislative process. Insurance reforms are always contentious and hard fought and we had the best of the best on our team this year. In the Senate, Senate Majority Leader Dominick Moreno (D, Commerce City) led efforts on this bill, along with long-time dental champion Sen. Perry Will (R, Rifle). In the House, the chair of the Health & Insurance Committee, Rep. Lindsey Daugherty (D, Arvada), and newly elected Rep. Anthony Hartsook (R, Parker) provided great support, ensuring that the bill moved forward through the calendar logjam that often occurs at the end of legislative sessions. Of note, Rep. Hartsook is a dental spouse and was instrumental in several dental policy reforms this session, understanding very directly how problematic dental plan policies impact dental practices and their patients.

Moving forward, the CDA will closely track the implementation of this bill. Several rounds of rulemaking are expected within the state Division of Insurance (DOI) in the months ahead. We will be following the key milestones below as the bill is implemented:

  • Aug. 6, 2023: Effective date for SB23-179
  • Late 2023 to Early 2024: DOI rulemaking to fully define DLR terminology to ensure a consistent reporting framework for carriers
  • March 31, 2024: A small “DOI’ indicator should begin appearing on patients’ dental plan cards when the plan is regulated by the state of Colorado, which should make it easier for dentists and patients to understand what laws and rules apply to their plans.
  • July 31, 2024: Dental plans first DLR report is due to the Division of Insurance (DOI) (and annually thereafter)
  • January 1, 2025: DOI publishes data from the 2024 DLR reports on a public website
  • January 2025: Legislative SMART hearings will be held to review data submitted in relation to SB23-179
  • Fall 2026: DOI rulemaking to identify outliers among carrier spending and related enforcement structures

SB23-179 is an important dental insurance reform policy that aims to improve transparency on dental insurance plan spending. This bill will help track where premium dollars are going, and give insights on how to maximize patient benefits going forward. Your patients pay a lot in dental insurance premiums, and they deserve for those funds to go to their dental treatment and care. The CDA played a key role in making sure this happens.