CA SB1008

Health care service plans and health insurers offering dental coverage must use a uniform benefits and coverage disclosure matrix starting January 1, 2021, or 12 months after regulations are adopted, whichever is later, to display deductibles, benefit limits, service categories (preventive, basic, major, orthodontia), reimbursement levels, waiting periods, and cost-sharing examples.

The Department of Managed Health Care and Department of Insurance must jointly develop the uniform dental benefits disclosure matrix in consultation with stakeholders and adopt it through emergency regulations.

Medical Loss Ratio (MLR) annual reports for dental coverage must be filed by July 31 of each year (changed from September 30) and posted on each department's website within 45 days of receipt.

Departments may issue guidance to health plans and insurers regarding compliance with MLR and disclosure requirements until formal regulations are adopted.

Exemptions apply to Medi-Cal dental managed care contracts, the Medi-Cal Access Program, and the California Major Risk Medical Insurance Program.