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Insurance department, providers and PERS debate dental loss‑ratio reporting and a 75% threshold; committee seeks more data
Summary
Senate Human Services members heard competing testimony on a proposal to require dental insurers to file standardized loss‑ratio reports and on whether to impose a statutory minimum that would require insurers to spend a specified share of premium on dental benefits.
Lawmakers and stakeholders debated House Bill 1481, a proposal to require dental insurers to report detailed dental loss‑ratio data to the state and to set a minimum dental loss‑ratio requirement intended to ensure consumers receive a stated share of premium back in dental benefits.
Crystal (Insurance Department staff) and department actuaries urged a phased, data‑first approach: require standardized reporting by insurers so the department can produce an apples‑to‑apples public report and then consider any statutory minimum later. The department’s proposed reporting language would require dental insurers that sell or offer coverage in the state to file an annual report organized by market (individual, small group, large group) and product type, in a format prescribed by the commissioner; the department would publish the information on its website.
Supporters of a statutory minimum loss ratio argued consumers and employers should see a larger portion of premium spent on benefits. William Sherwin of the North Dakota Dental Association said insurers should return a specified share of premium to policyholders in the form of dental care: “If you had a thousand dollars and we are able to reduce that interest rate from 6% to 2%,” Sherwin said in a different hearing about loan programs, “that 4% savings is $4,000,000 that goes back to the industry,” and later in dental testimony he argued for clear value for consumers. At the hearing Sherwin urged a plan‑level standard to ensure consistency across market segments and proposed an 83% benchmark as a fair level.
Representatives of insurers and trade groups warned that mandatory statutory thresholds can cause market disruption if they are set without standardized reporting and understanding of how individual plans and company books of business are structured. Dennis Pathroff of the American Council of Life Insurers pointed to department files showing multiple carriers in the market and said a simple “top‑two” share calculation in available spreadsheets could be misleading. Pathroff said plan‑level thresholds would have disqualified a large share of filings in recent years if applied retroactively.
Public plan stakeholders also weighed in. Rebecca Fricke of the Public Employees Retirement System (PERS) said PERS’ dental plan runs at a high loss ratio (her testimony cited the plan running in the high‑80s) and stressed that shifting insurers’ compliance costs could be passed on to employees if the market contracts. PERS did not take a formal position but asked for careful design to avoid unintended premium increases.
Department and committee discussion focused on two near‑term steps: adopt a robust, prescriptive reporting requirement for dental insurers (which the department can implement administratively) and delay any statutory minimum loss‑ratio enforcement until the department has collected and audited a year or more of standardized data. Committee members also discussed a delayed effective date (a 2026 or 2027 implementation was suggested) so the department can collect calendar‑year data and give insurers time to conform to a new reporting format.
No final committee vote was recorded. Stakeholders agreed to continue technical work with the insurance department to define the reporting format, the aggregation unit (insurer company vs. individual plan), and an appropriate timeline for any statutory minimum.
Key testimony and technical points: the insurance department said it can require and publish standardized annual reports on dental premium and claims if the committee directs it; insurers and trade groups warned that 75% plan‑level thresholds would have disqualified many recent filings; PERS highlighted its high loss‑ratio public plan and urged caution about shifting costs to employees.
The committee asked department staff and industry representatives to meet and craft uniform, auditable reporting specifications and to return with a refined proposal that balances consumer protections with market stability.
