1 of 1
SENATE DOCKET, NO. 1885 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 676
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Paul W. Mark
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to ensure consumer cost protection under the dental medical loss ratio.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :Paul W. MarkBerkshire, Hampden, Franklin and
Hampshire
Susannah M. Whipps2nd Franklin2/13/2023Joanne M. ComerfordHampshire, Franklin and Worcester2/13/2023Vanna Howard17th Middlesex2/13/2023James B. EldridgeMiddlesex and Worcester2/16/2023John Barrett, III1st Berkshire2/21/2023 1 of 2
SENATE DOCKET, NO. 1885 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 676
By Mr. Mark, a petition (accompanied by bill, Senate, No. 676) of Paul W. Mark, Susannah M.
Whipps, Joanne M. Comerford, Vanna Howard and other members of the General Court for
legislation to ensure consumer cost protection under the dental medical loss ratio. Financial
Services.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
_______________
An Act to ensure consumer cost protection under the dental medical loss ratio.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 1 of chapter 176X, as inserted by chapter 287 of the acts of 2022 is
2hereby amended by inserting before the definition of “Carrier” the following definition:-
3 “Annual benefit maximum”, the total dollar amount that a dental carrier will pay for a
4plan member’s care within the given plan year.
5 SECTION 2. Said section 1 of said chapter 176X, as so appearing, is hereby further
6amended by inserting after the definition of “Carrier” the following definition:-
7 “Cost-Sharing”, the share of costs for the services covered by the dental benefit plan that
8are paid out of a beneficiary’s pocket, including but not limited to co-pays, deductibles and co-
9insurance.
10 SECTION 3. Section 1 of said chapter 176X, as so appearing, is hereby further amended
11by inserting after the definition of “Dental benefit plans” the following definition:- 2 of 2
12 “Out-of-pocket costs”, expenses paid for dental care that are not reimbursed by insurance,
13including but not limited to: deductibles, coinsurance and copayments for covered services plus
14all costs for services that aren't covered.
15 SECTION 4. Notwithstanding any general or special law to the contrary, subsection (b)
16of section 2 of said chapter 176X as so appearing, is hereby amended by inserting in line 8, after
17the words “associated with paying claims.” the following sentence:-
18 The commissioner shall additionally require carriers offering dental benefit plans to
19submit information regarding out-of-pocket costs for dental plan members, including but not
20limited to: (i) annual benefit maximums, and (ii) cost-sharing including, but not limited to co-
21pays, deductibles, and co-insurance.
22 SECTION 5. Notwithstanding any general or special law to the contrary, subsection (c)
23of said section 2 of said chapter 176X as so appearing, is hereby further amended by inserting, in
24line 6, after the words “not actuarially sound.”, the following sentence:-
25 The commissioner may disapprove proposed changes to the base rates and changes to
26rating factors if the commissioner finds an increase in out-of-pocket costs paid by a carrier’s
27beneficiaries is unreasonable or excessive.