Requires insurers and corporations that issue, sell, renew or offer a specialized dental benefits plan policy or contract to report annually on data related to such dental benefits plan policies.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A3919B
SPONSOR: Weprin TITLE OF BILL:
An act to amend the insurance law, in relation to establishing a
requirement for information related to specialized dental benefit plans
PURPOSE:
To improve transparency and oversight of specialized dental benefit
plans by requiring insurers to report detailed plan data and making this
information publicly accessible.
SUMMARY OF PROVISIONS:
Section 1 amends Section 3231 of the insurance law to add a new
subsection requiring insurers offering specialized dental benefit plans
to file annual reports with the Superintendent of Financial Services.
These reports must include:
The number of covered persons, including how many reach the annual
coverage limit;
Plan cost-sharing and deductible amounts;
The annual maximum coverage limit.
The Superintendent is required to compile these reports and issue a
summary report to legislative leaders. Beginning the January after the
first submission, the data must be made publicly available online in a
searchable format.
Section 2 amends Section 4308 of the insurance law to impose the same
reporting requirements on non-profit medical and dental indemnity corpo-
rations that offer specialized dental plans.
Section 3 sets an immediate effective date and applies the bill to any
dental insurance policies issued or in effect on or after January 1,
2027.
JUSTIFICATION:
Currently, there is limited publicly available data about specialized
dental insurance coverage, including how many enrollees reach their
coverage limits or the structure of cost-sharing. This lack of transpar-
ency can prevent policymakers and consumers from making informed deci-
sions. By requiring standardized reporting and publishing of dental plan
data, this bill enhances oversight and promotes accountability in the
dental insurance market.
LEGISLATIVE HISTORY:
This is a new bill.
FISCAL IMPLICATIONS:
None to the state.
EFFECTIVE DATE:
This act shall take effect immediately and shall apply to any policies
issued or in effect on and after January 1, 2027.
STATE OF NEW YORK
________________________________________________________________________
3919--B
Cal. No. 118
2025-2026 Regular Sessions
IN ASSEMBLY
January 30, 2025
___________
Introduced by M. of A. WEPRIN, HEVESI, TAYLOR, PAULIN, BROOK-KRASNY,
KAY, JACOBSON -- read once and referred to the Committee on Insurance
-- committee discharged, bill amended, ordered reprinted as amended
and recommitted to said committee -- ordered to a third reading,
amended and ordered reprinted, retaining its place on the order of
third reading
AN ACT to amend the insurance law, in relation to establishing a
requirement for information related to specialized dental benefit
plans
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 3231 of the insurance law, as added by chapter 501
2 of the laws of 1992, is amended by adding a new subsection (j) to read
3 as follows:
4 (j) (1) Any insurer that issues, sells, renews, or offers a special-
5 ized dental benefits plan policy or contract shall be required to file
6 an annual report with the superintendent organized by market and product
7 type which shall include, but not be limited to, the following informa-
8 tion:
9 (A) the number of covered persons, including the number of covered
10 persons that meet or exceed the annual coverage limit;
11 (B) plan cost-sharing and deductible amounts; and
12 (C) the annual maximum coverage limit.
13 (2) The report required by this subsection shall be based on the
14 fiscal year during which the dental coverage is provided by the plan.
15 (3) The superintendent shall issue a report on the data collected
16 pursuant to this subsection to the speaker of the assembly and the
17 temporary president of the senate. The superintendent's report shall
18 include the data collected from all insurers required to report pursuant
19 to this subsection.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07555-04-6
A. 3919--B 2
1 (4) Beginning on the first of January following the submission of the
2 first report required to be filed pursuant to this subsection, and annu-
3 ally thereafter, the superintendent shall make collected dental loss
4 ratio information available to the public in a searchable format on a
5 public website by plan type.
6 § 2. Section 4308 of the insurance law is amended by adding a new
7 subsection (c-1) to read as follows:
8 (c-1)(1) Any corporation that issues, sells, renews, or offers a
9 specialized dental benefits plan policy or contract shall be required to
10 file an annual report with the superintendent organized by market and
11 product type which shall include, but not be limited to, the following
12 information:
13 (A) the number of covered persons, including the number of covered
14 persons that meet or exceed the annual coverage limit;
15 (B) plan cost-sharing and deductible amounts; and
16 (C) the annual maximum coverage limit.
17 (2) The report required by this subsection shall be based on the
18 fiscal year during which the dental coverage is provided by the plan.
19 (3) The superintendent shall issue a report on the data collected
20 pursuant to this subsection to the speaker of the assembly and the
21 temporary president of the senate. The superintendent's report shall
22 include the data collected from all corporations required to report
23 pursuant to this subsection.
24 (4) Beginning on the first of January following the submission of the
25 first report required to be filed pursuant to this subsection, and annu-
26 ally thereafter, the superintendent shall make collected dental loss
27 ratio information available to the public in a searchable format on a
28 public website by plan type.
29 § 3. This act shall take effect immediately and shall apply to any
30 policies issued or in effect on and after January 1, 2027.
