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HB 6816

AN ACT ESTABLISHING A MEDICAL LOSS RATIO FOR DENTAL INSURANCE.

2025 Regular Session Introduced by Mary Mushinsky

Connecticut bill requiring dental insurers to spend minimum percentage of premiums on claims rather than administrative costs, mirroring health insurance regulations.

REF. TO JOINT COMM. ON Insurance and Real Estate
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Bill Summary · HB 6816

Legislative bill overview

HB 6816 would establish a medical loss ratio (MLR) requirement for dental insurance plans in Connecticut. A medical loss ratio is the percentage of premium revenues that insurers must spend on actual healthcare claims versus administrative costs and profits. This bill applies similar regulatory standards already used in health insurance to the dental insurance market.

Why is this important

Dental insurance operates with less regulatory oversight than health insurance in most states, often allowing insurers to keep a higher percentage of premiums for administrative expenses and profits rather than paying claims. Establishing an MLR for dental insurance could lower out-of-pocket costs for consumers by ensuring more premium dollars go toward actual dental care, while also increasing transparency about insurer spending practices.

Potential points of contention

  • Insurer costs and market impact: Dental insurers may argue that MLR requirements could reduce their profit margins, potentially leading to higher premiums, reduced plan options, or market exits in Connecticut
  • Different market dynamics: Dental insurance has different claims patterns and cost structures than medical insurance, raising questions about whether the same MLR thresholds are appropriate
  • Regulatory precedent and scope: Questions about what specific MLR percentage should apply (typically health insurance requires 80-85%) and whether Connecticut has authority to impose this without federal coordination

Compiled from official sources — confirm details with the bill’s official record.

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