Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 44 First Substitute (2017GS)

Sponsor

Sen. Christensen, A.

Final action

Governor Signed 3/17/2017

Outcome

Became law — signed by Gov. Gary R. Herbert

Summary

What it does

• This bill:
• defines terms;
• prohibits a dental insurer from setting fees for dental services that are not covered services under the dental insurance; and
• applies to dental plans entered into or renewed on or after January 1, 2018.

Every vote on this bill

Bill text

DENTAL INSURANCE AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Allen M. Christensen
House Sponsor: 
Raymond P. Ward
LONG TITLE
General Description:
This bill regulates certain contract provisions for dental services.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ prohibits a dental insurer from setting fees for dental services that are not covered
services under the dental insurance; and
▸ applies to dental plans entered into or renewed on or after January 1, 2018.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
ENACTS:
31A-22-645
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
31A-22-645
 is enacted to read:
 31A-22-645.
Dental insurance -- Contract provision for noncovered services.
(1) For purposes of this section:
(a) "Covered services" means dental services for which reimbursement:
(i) is available or would be reimbursable under an enrollee's dental plan but for the
application of one or more of the following contractual provisions:
(A)
 deductibles[
,
]
;
(B)
 copayments[
,
]
;
(C)
 coinsurance[
,
]
;
(D)
 waiting periods[
,
]
;
(E)
 annual or lifetime maximums[
,
]
;
(F)
 frequency limitations[
,
]
; or
(G)
 alternative benefit payments[
, or any other limitation
]; and
(ii) is not merely nominal, for the purpose of avoiding the requirements of this section.
(b) "Dental plan"means:
(i) a health benefit plan that includes coverage for dental services; and
(ii) a policy or certificate that provides coverage solely for dental services.
(c) "Dentist" means an individual licensed under Tile 58, Chapter 69, Dentist and
Dental Hygienist Practice Act.
(2) (a) This section applies to:
(i) a dental plan that is entered into or renewed on or after January 1, 2018; and
(ii) an administrator providing third-party administration services or a provider
network for a dental plan.
(b) This section does not apply to a self-insured dental plan that is regulated by federal
law.
(3) A contract between a dental plan and a dentist to provide covered services may not:
(a) require, directly or indirectly, that a dentist provide dental services to a covered
individual at a fee set by, or a fee subject to the approval of, the dental plan unless:
(i) the dental services are covered services under the dental plan; or
(ii) (A) the dental services are not reimbursed by the dental plan;
(B) the dental services are discounted for individuals who are part of a discount dental
rates plan; and
(C) the dentist who provided the dental services has elected to participate in the
discount dental rates plan; and
(b) prohibit a dentist from offering or providing noncovered dental services to a
covered individual at a fee determined by the dentist and the individual who will receive the
noncovered services.