How much of your dental insurance premium goes into your mouth? – InsuranceNewsNet


“We encourage voters through Massachusetts vote YES to question 2 to improve access to quality dental care and better dental benefits.

dr. André Tonelli

committee spokesperson and MDS co-chair

Massachusetts Voters face four statewide questions in the November ballot: Question 1 deals with taxation of high-income earners, Question 2 deals with dental insurance, Question 3 deals with liquor licenses and question 4 of who is allowed to apply for a Massachusetts Driving license.

The first three questions are listed and explained in the red ‘Voter Information’ booklet sent out this week by the Secretary of State by William Galvin Desk. Question 4 was a latecomer; signatures for the initiative to be on the ballot were not submitted to Galvin’s office before the booklets went to press.

Local issues are also not included in the booklet. These are printed only on local ballot papers. There are a few: Belmont together, Brookline, hingham, Wrentham, Natick, worcester, Westborough and Burlington also have local issues, according to Galvin’s office. Some take care of fire stations (Brookline) a library and a public ice rink (Belmont).

Binding questions come first on local ballots, non-binding public policy questions are at the bottom of the ballots.

How much dental insurance premium should I pay for dental treatment?

In terms of statewide issues: Question 2 refers to the dental insurance industry and asks voters to decide whether insurance companies should be required to spend 83% of dollar premiums for patient care.

Taking a closer look at question 2, voters may wonder if it really matters how much of their dental insurance premiums end up in their mouths. Massachusetts already requires health insurance companies to allocate 88% of premium dollars to patient care, known as a medical loss ratio. Any excess is systematically reimbursed. This initiative would extend the same criteria to dental insurance companies.

The measure is supported by the Massachusetts Dental Society (MDS) and the American Dental Association (ADA). Patients, they argue, deserve to know how much of their premium is used for their actual care, as opposed to how much is allocated to administrative costs and how much is profit.

“We encourage voters through Massachusetts to vote YES to question 2 to improve access to quality dental care and better dental benefits,” said Dr. André TonelliCommittee Spokesperson and Co-Chair of the MDS Government Affairs Committee and Past Chair of the Boston District Dental Society. “This ballot initiative would make dental insurers more transparent and accountable to the patients they serve.”

This would ensure that patient premium dollars are spent on patient care, Tonelli said.

A study commissioned by National Association of Dental Plans reviewed the costs and benefits of the proposal. He found most of Massachusetts dental insurers allocate between 60% and 79% of premiums to patient care; depending on company size, with smaller companies allocating fewer dollars while larger companies allocating more. The rest of the premiums billed are used, in part, for administrative costs.

The study by the Millimman Research The group found that the proposal would impact companies with a smaller pool of customers, as the administrative costs of insuring patients are borne by fewer customers. Additionally, the cost of fulfilling the 83% mandate, coupled with the cost of rebates, would impact the company’s revenue.

In the “Information for Voters” booklet, an example to illustrate the need for this reform cites a 2019 form prepared by Delta Dental (Form 990) which lists executive bonuses, commissions and payments to affiliates at $382 million and patient care costs of $177 million.

“We view the approval of the ballot measure as a watershed moment in the way dental insurance is provided to patients,” said Cesar R. SabatesDDS, president of the American Dental Association. “Dental plans should serve patients first, and the companies that offer them should embrace transparency and accountability, rather than hide from it.”

State approval for premium increases

If passed, the measure would also require any increase in dental insurance premium costs to be approved by the state. Insurance Divisionjust like medical insurance premiums.

At a recent meeting, the state’s Health Connector Board approved an increase in medical insurance rates that averages 7.6% for insurance coverage purchased through the Health Connector. Some 85,474 unsubsidized customers or those who receive advance premium tax credits and purchase through the Health Connector would be affected by the rate increase.

“We encourage voters through Massachusetts vote YES to question 2 to improve access to quality dental care and better dental benefits.

dr. André Tonelli

committee spokesperson and MDS co-chair


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