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WSDA

HB 1002 brings more transparency to dental insurance

Friday morning, Governor Inslee signed Substitute House Bill 1002 into law.
Friday morning, Governor Inslee signed Substitute House Bill 1002 into law. The new law does two important things for dentistry in Washington:
 
1.)    Prohibits insurance companies from denying coverage for same-day emergency treatment.
2.)    Requires that dental carriers submit loss ratio statements to the Office of the Insurance Commissioner. This information will increase transparency and accountability by disclosing how patient premium dollars are being spent. A loss ratio is the percentage of premium dollars that are spent on patient care. Washington is the second state in the nation to require dental loss ratio disclosure. Similar legislation was passed in California in 2014.

It’s no secret that insurance plans have made providing some aspects of dental care difficult. That’s why this legislation is so important – and the dental profession has many people to thank for making it happen.
 
WSDA members Dr. Cindy Pauley and Dr. Amy Cook saw a problem and proactively got to work to fix it. Working with former Representative Cathy Dahlquist and Representative Richard DeBolt, they wrote a bill to address many of the problems dentists face due to rigid insurance requirements. The original version of the legislation addressed twelve concerns. For example, the legislation would have prohibited insurance companies from requiring clinically unnecessary x-rays. These twelve points were – and continue to be –  important, but the Legislature is a place of incremental change.
 
During the early stages of the current legislative session, Representative DeBolt brought together a diverse group of stakeholders including insurance carriers, dentists, WSDA, legislative staff, and Representative Michelle Caldier. Together, they brokered an agreement that all parties agreed to support – limiting the legislation to the two provisions described above. The importance of Representative DeBolt’s collaborative work to bring all of the stakeholders together to find common ground cannot be understated; this work made passage of HB 1002 possible.
 
Passing loss ratio legislation has been a legislative priority for WSDA. In 2014, the WSDA House of Delegates passed HD-9-2014 that called on the organization to work with legislators, insurance carriers, advocacy organizations and other stakeholders to support legislation that requires all dental plans to meet a minimum loss ratio standard. Over the course of the last year, WSDA had a series of meetings with the Office of the Insurance Commissioner and others to draft legislative language concerning loss ratios which proved very useful in determining the final language included in HB 1002.
 
The combined efforts of everyone involved resulted in a substitute bill that faced no opposition as it worked its way through the legislative process. Working together resulted in meaningful changes to aid the dental profession – and patients throughout our state will be helped.
 
This legislation is an excellent example of what is possible when dentists, legislators, and other partners unify together. We look forward to building on this success in 2016 and beyond.
 
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