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Proposal would require dental insurers to rebate premiums if less than 80% is paid in claims
Summary
Senate Bill 335 would require stand‑alone dental insurers licensed in Montana to report a dental loss ratio and rebate premiums to policyholders if less than 80% of premium dollars are paid in claims. Dentists and hygienists backed the bill as consumer protection; insurers warned it could raise premiums and shrink market participation.
Senate Bill 335, sponsored in the House by Sen. Greg Hertz, would require dental insurers that issue stand‑alone dental plans in Montana to meet an 80% dental loss ratio (DLR). If a plan’s claims payments fall below 80% of premium after allowable adjustments, the insurer would have to rebate the difference to covered policyholders.
Proponents including the Montana Dental Association and the Montana Dental Hygienists Association framed the bill as a consumer‑protection measure that forces transparency and returns more premium dollars to patient care. Dr. Michael Bowman, president of the Montana Dental Association, told members he sees patients who pay substantial premiums yet receive little value; Webb Brown (MDA) and dental hygienists repeated examples of low annual benefit caps and frustrating customer experiences. Witnesses noted the bill follows model language used in other states and in a national NCOIL discussion; supporters referenced Washington state, Massachusetts and other jurisdictions as precedent for state DLR actions.
Insurers and trade groups — including Delta Dental, AHIP, the National Association of Dental Plans, Blue Cross Blue Shield of Montana, MetLife, Guardian, Emblem (Emeritus) and others — strongly opposed the mandatory 80% standard. Opponents argued dental insurance differs from medical insurance: typical dental premiums are small (witnesses said average dental premium in Montana totals about $35 per month for some plans and that statewide dental premium volumes are on the order of tens of millions of dollars), so an 80% minimum would leave very little per‑member, per‑month to cover required administration, network management and consumer services. Delta Dental and others said the only ways to meet a hard 80% target would be (a) raise premiums substantially (some carriers said meeting 80% would require roughly doubling premiums in their modeling), (b) reduce plan choices or network size, or (c) exit markets for some segments (Massachusetts saw several plans leave after a 2022 ballot initiative requiring an 80% DLR was enacted).
Proponents said the bill applies only to stand‑alone dental plans (not dental benefits embedded inside medical plans, Medicare, or Healthy Montana Kids). Sponsor Sen. Hertz said the measure is meant to give consumers better value for premium dollars and noted the bill’s effective date would apply to plans issued or renewed after Jan. 1, 2026. The committee heard extensive testimony and a series of insurers and industry associations urged the committee to require reporting and study rather than a hard statutory minimum. No committee vote was recorded in the transcript.
