Bill Text: NY S07013 | 2023-2024 | General Assembly | Introduced
Bill Title: Establishes a medical loss ratio for dental insurance of not less than 82% for calendar year 2024 and thereafter.
Spectrum: Moderate Partisan Bill (Democrat 5-1)
Status: (Introduced) 2024-01-03 - REFERRED TO INSURANCE [S07013 Detail]
Download: New_York-2023-S07013-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 7013 2023-2024 Regular Sessions IN SENATE May 16, 2023 ___________ Introduced by Sen. BRESLIN -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to establishing a medical loss ratio for dental insurance The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 3 of subsection (e) of section 3231 of the 2 insurance law, as added by chapter 107 of the laws of 2010, is amended 3 to read as follows: 4 (3) (a) All policy forms subject to this subsection, other than medi- 5 care supplemental insurance policy forms, but including policy forms 6 covering any dental services where a premium is collected, issued or in 7 effect during calendar year two thousand ten shall be subject to a mini- 8 mum loss ratio requirement of eighty-two percent. Insurers may use the 9 alternate filing procedure set forth in paragraph two of this subsection 10 to adjust premium rates in order to meet the required minimum loss ratio 11 for calendar year two thousand ten. The rate filing or application shall 12 be submitted no later than September thirtieth, two thousand ten. 13 (b) The expected minimum loss ratio for a dental policy form subject 14 to this subsection issued or in effect during and after calendar year 15 two thousand twenty-four, other than a medicare supplemental insurance 16 contract, shall not be less than eighty-two percent. In reviewing a rate 17 filing or application, the superintendent may modify the eighty-two 18 percent expected minimum loss ratio requirement if the superintendent 19 determines the modification to be in the interests of the people of this 20 state or if the superintendent determines that a modification is neces- 21 sary to maintain insurer solvency. No later than July thirty-first of 22 each year, every corporation subject to this subparagraph shall annually 23 report the actual loss ratio for the previous calendar year in a format 24 acceptable to the superintendent. If an expected loss ratio is not met, 25 the superintendent may direct the corporation to take corrective action, EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD11481-01-3S. 7013 2 1 which may include the submission of a rate filing to reduce future 2 premiums, or to issue dividends, premium refunds or credits, or any 3 combination of these. For the purposes of this subsection with respect 4 to dental policy forms, "minimum loss ratio" shall mean the required 5 minimum percentage that dental insurance plans must dedicate for patient 6 care rather than administrative and overhead cost. If not met, the 7 difference must be refunded to individuals or group policy owners in the 8 form of a rebate. 9 § 2. Subparagraph (A) of paragraph 3 of subsection (c) of section 10 4308 of the insurance law, as amended by section 62 of part D of chapter 11 56 of the laws of 2013, is amended and a new subparagraph (C) is added 12 to read as follows: 13 (A) The expected minimum loss ratio for a contract form subject to 14 this subsection for which a rate filing or application is made pursuant 15 to this paragraph, other than a medicare supplemental insurance 16 contract, but including a dental insurance contract, or, with the 17 approval of the superintendent, an aggregation of contract forms that 18 are combined into one community rating experience pool and rated 19 consistent with community rating requirements, shall not be less than 20 eighty-two percent. In reviewing a rate filing or application, the 21 superintendent may modify the eighty-two percent expected minimum loss 22 ratio requirement if the superintendent determines the modification to 23 be in the interests of the people of this state or if the superintendent 24 determines that a modification is necessary to maintain insurer solven- 25 cy. No later than July thirty-first of each year, every corporation 26 subject to this subparagraph shall annually report the actual loss ratio 27 for the previous calendar year in a format acceptable to the superinten- 28 dent. If an expected loss ratio is not met, the superintendent may 29 direct the corporation to take corrective action, which may include the 30 submission of a rate filing to reduce future premiums, or to issue divi- 31 dends, premium refunds or credits, or any combination of these. 32 (C) (i) The expected minimum loss ratio for a dental contract form 33 subject to this subsection for which a rate filing or application is 34 made pursuant to this paragraph, other than a medicare supplemental 35 insurance contract, shall not be less than eighty-two percent. In 36 reviewing a rate filing or application, the superintendent may modify 37 the eighty-two percent expected minimum loss ratio requirement if the 38 superintendent determines the modification to be in the interests of the 39 people of this state or if the superintendent determines that a modifi- 40 cation is necessary to maintain insurer solvency. No later than July 41 thirty-first of each year, every corporation subject to this subpara- 42 graph shall annually report the actual loss ratio for the previous 43 calendar year in a format acceptable to the superintendent. The depart- 44 ment shall make available to the public all data provided pursuant to 45 this section. 46 (ii) If an expected loss ratio is not met, the superintendent may 47 direct the corporation to take corrective action, which may include the 48 submission of a rate filing to reduce future premiums, or to issue divi- 49 dends, premium refunds or credits, or any combination of these. 50 § 3. This act shall take effect immediately and shall apply to any 51 policies issued or in effect on and after January 1, 2024.
