2024 Health Meeting - Session 4D: Commercial Dental Plans—Recent Regulatory Changes 6.24.24 Recording

This session will focus on the latest regulatory changes impacting commercial dental plans, including recent developments in Minimum Loss Ratio Requirements (MLR) and the potential inclusion of adult dental services as an Essential Health Benefit (EHB). Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or considered minimum loss ratio regulations for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. HHS and CMS released the 2025 Proposed Notice of Benefit and Payment Parameters, which included a provision that acknowledges the importance of oral health by allowing qualified health plan (QHP) issuers to include routine, non-pediatric dental services – which may include adult dental services – as essential health benefits (EHBs). This session will lead a discussion on the latest developments in these two regulatory changes. Attendees will learn about these hot topics, recent legislative activity in the dental loss ratio space, and the pricing and risk management implications of including adult services as an Essential Health Benefit.