New state law will create more transparency of dental insurance benefits

A new state law will make it easier for consumers and businesses to determine the dental insurance plans that pay the most for patient procedures such as fillings and root canals.

"Starting this year, all the dental insurance companies that operate in Mississippi will have to provide the Mississippi Insurance Department what percentage of the premium dollars they're collecting from patients is being paid out on patient care," said Wahnee Sherman, executive director of the Mississippi Dental Association.

"Even if you wanted to know, until this law was passed there was no way to have access to this information. There has been no objective data out there for businesses, school systems and individual Mississippians to use."

Dr. Peter Boswell, a Jackson dentist and president of the 800-member association, said patients, who want to buy dental insurance on their own, and business owners, who offer dental insurance as a benefit for their employees, ask him questions about it almost every day.

"Patients often ask, 'Which insurance company should I go with? Which one pays the best?" said Boswell, whose father and grandfather were also dentists. "What's helpful about this new law is that it will help patients know the companies that will take care of them."

Sherman said the new law is a major improvement for individual consumers shopping for dental insurance and for businesses because they will be able to make comparisons using the data.

The law called for all carriers that renew, deliver or issue a dental healthcare service plan in Mississippi "to file a dental loss ratio annual report for the preceding calendar year to the insurance commissioner no later than June 2026 and annually thereafter, no later than June 30 of each calendar year."

Dental loss ratio refers to the percentage of premium dollars spent on patient care, and the new law outlines how that should be calculated.

The annual report should be "organized by market and product type, contain the same information as required by the 2013 federal Centers for Medicare & Medicaid Services Medical Loss Ratio Annual Reporting Form, provide the number of enrollees, the plan cost-sharing, deductible amounts, the annual maximum coverage limit and the number of enrollees who meet or exceed the annual coverage limit."

The law provides for the insurance commissioner to request additional information to verify a plan's representation of its data.

The data loss ratio annual report filed with the commissioner should be available to the public no later than Dec. 1, 2026, and annually after that, no later than Dec. 1 of each calendar year. The insurance commission is required to post the information in a searchable format on the department's website.

The law does not apply to benefit plans that are Medicaid, the Mississippi Children's Health Insurance Program or other state-sponsored plans.

Sherman said the association hopes the new law will encourage insurance companies to use more premium dollars toward patient care.

"Right now, we don't know what those numbers look like," she said. "In other states that have passed similar legislation, there were companies that were putting 25 percent or 30 percent into patient care. That's 25 cents on the dollar."

Sen. Walter Michel (District 25-Hinds, Madison counties) sponsored the bill in the Senate, and Rep. Hank Zuber (District 113-Jackson County) in the House of Representatives.

The Mississippi Dental Association has been working for the last three years to get a dental transparency bill passed, she said. "This year the bill passed unanimously in the House and the Senate," she said.

About 20 other states have similar laws about dental insurance transparency, she said.

Michel said the Mississippi law is modeled after one from the National Council of Insurance Legislators.

"In 24 to 36 months, we'll have good data about what percentage of premiums go toward patient dental care," he said.

He said some people wanted to set the percentage that dental insurance providers should spend on patient care, but the Legislature did not do that.

Michel said the thinking was, "Ler's get the data first and make this a transparency bill before we tackle that."