SF 1204

Introduction - 94th Legislature (2025 - 2026)

Posted on 02/11/2025 11:15 a.m.

A bill for an act
relating to insurance; requiring dental organizations to meet a loss ratio requirement;
amending Minnesota Statutes 2024, section 62Q.76, by adding a subdivision;
proposing coding for new law in Minnesota Statutes, chapter 62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 62Q.76, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of commerce.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026.
new text end

Sec. 2.

new text begin [62Q.761] DENTAL LOSS RATIO.
new text end

new text begin Subdivision 1. new text end

new text begin Loss ratio calculation. new text end

new text begin Dental loss ratio is equal to the total claims paid
by a dental organization divided by gross premium revenue received by the dental
organization for providing dental care services to enrollees.
new text end

new text begin Subd. 2. new text end

new text begin Rebate. new text end

new text begin (a) A dental organization's dental loss ratio calculated under subdivision
1 must be at least 85 percent.
new text end

new text begin (b) A dental organization that does not meet the dental loss ratio under paragraph (a)
must provide remediation to the dental organization's enrollees. Remediation may be achieved
by issuing a direct rebate to enrollees, an increase in dental plan benefit limits for the
following year, or other methods determined by the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin Rate review and approval. new text end

new text begin A dental organization must file with the
commissioner proposed changes to premium rates that are effective during the next calendar
year. The commissioner may disapprove a proposed rate change using the standards under
section 62A.02, subdivision 3.
new text end

new text begin Subd. 4. new text end

new text begin Reporting. new text end

new text begin (a) By March 1, 2027, a dental organization must submit a report
to the commissioner showing the dental organization's dental loss ratio for each year of the
prior three calendar years and an actuarial memorandum disclosing the financial information
that was used to calculate the dental loss ratio.
new text end

new text begin (b) By March 1, 2028, and each year thereafter, a dental organization must submit a
report to the commissioner showing its dental loss ratio for the previous calendar year, an
actuarial memorandum disclosing the financial information that was used to calculate the
dental loss ratio, a detailed summary of any proposed rate change filed under subdivision
3, and any other information determined by the commissioner.
new text end

new text begin (c) The commissioner must publish on the Department of Commerce's website an annual
report containing the information submitted by a dental organization under paragraphs (a)
and (b). The information must be published in a manner that allows the public to search and
compare the dental loss ratios of all dental organizations.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) Subdivision 1 is effective January 1, 2026.
new text end

new text begin (b) Subdivision 2 is effective January 1, 2028.
new text end

new text begin (c) Subdivisions 3 and 4 are effective January 1, 2027.
new text end