Nevada improves medical loss ratio law for dental plans

Nevada Gov. Joe Lombardo signed a new medical loss ratio bill into law on June 1 that reaffirms a requirement established in 1983 that dental insurers in that state spend at least 75% of premium revenue on dental care.

“It’s a great step forward,” said Jason Doucette, D.M.D., president of the Nevada Dental Association. “While we’ve had medical loss ratio on the books for years, there was no enforcement or transparency, and without those ingredients, it wasn’t doing patients much good.”

According to the new law, dental plans that do not meet the 75% threshold have an excessive rate. When that occurs, the law further empowers the commissioner of insurance to order insurers with excessive rates to decrease rates charged to patients or otherwise compensate insureds affected by the excessive rates.

The enactment in Nevada is part of a larger story. Medical loss ratio appears to be a trending issue around the country with bills introduced in 12 states. Nevada dentists point to the ballot measure win in Massachusetts in November 2022 as spurring the issue along in their state. 

“I believe we wouldn’t have been successful [in Nevada] if it wasn’t for the Massachusetts ballot that passed,” said Michele Reeder, executive director of the Nevada Dental Association. 

The ADA invested $5.5 million to support the effort in Massachusetts and continues to assist states like Nevada on their dental insurance reform efforts around the country.

In terms of improved transparency, the new Nevada law requires dental insurers to annually report their medical loss ratio to the insurance commissioner where it must be posted on the commissioner’s website. The commissioner may investigate discrepancies in insurers’ reporting to ensure the data is accurate.  If the verified data shows the insurer falls into the excessive rate category, i.e., not spending at least 75% of revenue on patient care, the insurer must submit a plan to adjust its rates. 

“While we faced a great deal of opposition from the dental insurance industry, we were thrilled to prevail at the end of the legislative session,” said Dr. Doucette. “Nevada patients will benefit from knowing more about their dental plans. Plus, they will receive greater value from those plans because 75 percent of their premiums need to go toward their care.”

“We’re excited about moving this issue forward on behalf of our patients,” he added. “More premiums going to patient care will translate to better oral health in our state.”