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AZ SB1302
Bill
Status
1/30/2023
Primary Sponsor
John Kavanagh
Click for details
AI Summary
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Requires dental service corporations, health care services organizations, disability insurers, group disability insurers, and blanket disability insurers to file annual medical loss ratio (MLR) reports with the department by March 31 for the preceding calendar year, organized by market and product type.
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Mandates rebates to subscribers/enrollees/insureds on a pro rata basis by August 1 if MLR falls below 85% for large group markets or below 80% for small group markets, with rebate amounts calculated as the percentage shortfall multiplied by total premium revenue.
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Establishes presumptive denial of group product base rates and rating factors if administrative expense loading increases more than the consumer price index for dental services, contribution to surplus exceeds 1.9%, or aggregate MLR falls below 85% (large group) or 80% (small group).
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Requires insurers to file group product base rates and rating factor changes by July 1 of the preceding year for January 1 effectiveness and allows department to deny rates that are excessive, inadequate, unreasonable, discriminatory, or not actuarially sound.
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Requires insurers to notify all covered individuals when the department presumptively denies rates and prohibits implementation of denied rates unless reversed by the department or court.
Legislative Description
Dental insurance; medical loss ratio
Definitions
Last Action
Senate read second time
1/31/2023