S.B. No. 87 Summary

• Prohibits health insurers from establishing fee schedules for dental services that are not covered by any contract or participating provider agreement between the insurer and the dental provider.

• Adds unfair and deceptive insurance practice provisions preventing insurers from setting or requiring approval of fees for non-covered dental services or making health benefit plans that set such fees available.

• Exempts health benefit plans subject to federal Employee Retirement Income Security Act (ERISA) regulation from these requirements.

• Amends definitions and contract requirements in health care provider sections to clarify "covered dental services" means only services for which reimbursement is available under an enrollee's plan, excluding those subject to contractual limitations like deductibles or waiting periods.

• States the General Assembly's intent that insurers cannot use minimal reimbursement strategies for non-covered services to circumvent this prohibition.