The Connecticut State Legislature has introduced House Bill 6816, aimed at establishing a medical loss ratio (MLR) for dental insurance. Introduced by Representative Mary Mushinsky of the 85th District on January 29, 2025, the bill seeks to regulate how much of the premium revenue collected by dental insurance companies must be spent on patient care versus administrative costs and profits.

The primary provision of the bill mandates that dental insurers allocate a minimum percentage of their premiums towards direct patient care, similar to existing regulations for health insurance. This move is intended to enhance transparency and ensure that consumers receive a fair value for their insurance premiums, addressing concerns that a significant portion of funds may be diverted to administrative expenses rather than dental services.

As the bill progresses, it has sparked discussions among stakeholders in the insurance and dental industries. Proponents argue that establishing an MLR for dental insurance will protect consumers and promote better health outcomes by ensuring that more funds are directed towards necessary dental care. Critics, however, express concerns that such regulations could lead to increased premiums or reduced coverage options as insurers adjust to comply with the new requirements.

The implications of House Bill 6816 could be significant for both consumers and insurance providers in Connecticut. If passed, it may set a precedent for similar regulations in other states, potentially reshaping the landscape of dental insurance. Experts suggest that the bill could lead to improved access to dental care for residents, particularly those who may have previously faced barriers due to high out-of-pocket costs.

As the bill moves to the Insurance and Real Estate Committee for further consideration, stakeholders will be closely monitoring its progress and potential impact on the dental insurance market in Connecticut.