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Bill

SB 1002

AN ACT ESTABLISHING A MEDICAL LOSS RATIO FOR DENTAL INSURANCE.

2025 Regular Session Introduced by Martin Looney and 1 co-sponsor

Connecticut would require dental insurers to spend a minimum percentage of premiums on dental care rather than overhead, potentially increasing coverage value but possibly raising premiums.

REF. TO JOINT COMM. ON Insurance and Real Estate
#dentalcare #insurance
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Bill Summary · SB 1002

Legislative bill overview

SB 1002 would establish a medical loss ratio (MLR) requirement for dental insurance plans in Connecticut. A medical loss ratio mandates that insurers spend a minimum percentage of premium revenues on actual dental care and treatment rather than administrative costs and profits. This would mirror existing MLR requirements that apply to health insurance under the Affordable Care Act.

Why is this important

Dental insurance consumers often experience high out-of-pocket costs despite paying premiums, partly because dental insurers can allocate significant portions of premiums to administrative expenses and profits. Establishing an MLR floor would theoretically redirect more premium dollars toward actual dental services, potentially making coverage more valuable and affordable for patients. However, this affects a substantial market segment—dental insurance is purchased by millions of Americans and represents significant industry revenue.

Potential points of contention

  • Insurance industry opposition: Insurers may argue that MLR requirements reduce flexibility in pricing models, limit profitability, and could lead to premium increases or market withdrawal from Connecticut
  • Definitional complexity: Determining what counts as "medical loss" versus administration in dental care is technically complex and could create disputes between regulators and insurers
  • Market impact uncertainty: Unclear whether an MLR mandate would improve affordability or simply shift costs to premiums, potentially pricing lower-income consumers out entirely

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

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