NJ A4166

Dental plans offered by insurance carriers in New Jersey must provide coverage with benefits actuarially equivalent to the full actuarial value as determined by the Commissioner of Banking and Insurance

Provider reimbursement for covered dental services must be at least 75 percent of the usual and customary charge for the service

The Commissioner must develop procedures to determine usual and customary charges for dental services on a regional basis, with separate determinations for at least three areas: northern, central, and southern New Jersey

Coverage levels must be calculated based on a standard population rather than the actual population enrolled in the plan

Takes effect on the first day of the third month following enactment and applies to dental plans delivered, issued, executed, or renewed after that date