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S. B. No. 2479 *SS26/R598.1* ~ OFFICIAL ~ G1/2
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To: Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026
By: Senator(s) Michel, Blackwell, McMahan,
Frazier, Rhodes, Chassaniol, England,
McLendon, Fillingane, DeLano, Wiggins,
Blount, Younger, Suber, Kirby, Boyd, Thomas,
Harkins, DeBar, Blackmon
SENATE BILL NO. 2479
AN ACT TO ENACT THE "CREATING TRANSPARENCY AND ACCOUNTABILITY 1
IN DENTAL SERVICES ACT"; TO PROVIDE DEFINITIONS; TO PROVIDE FOR 2
TRANSPARENCY OF DENTAL PATIENT PREMIUM EXPENDITURES AND ANNUAL 3
REPORTING; AND FOR RELATED PURPOSES. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 5
SECTION 1. This act shall be known and may be cited as the 6
"Creating Transparency and Accountability in Dental Services Act." 7
The purpose of this act is to provide for transparency and 8
accountability of the expenditures of dental healthcare service 9
plan premiums and to require annual reporting. 10
SECTION 2. Definitions. For the purposes of this act, the 11
following words and phrases shall have the meanings as defined 12
herein unless the context clearly indicates otherwise: 13
(a) "Dental carrier" or "carrier" means a dental 14
insurance company, dental service corporation, dental plan 15
organization authorized to provide dental benefits, or a health 16
insurance plan that includes coverage for dental services. 17
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(b) "Dental healthcare service plan" or "plan" means 18
any plan that provides coverage for dental healthcare services to 19
enrollees in exchange for premiums. 20
(c) "Dental loss ratio" or "DLR" means a percentage of 21
premium dollars spent on patient care as calculated pursuant to 22
this act. 23
(d) "Commissioner" and "department" refer to the 24
Mississippi Insurance Commissioner and Mississippi Insurance 25
Division, respectively. 26
SECTION 3. Transparency of patient premium expenditures and 27
annual reporting. (1) Dental loss ratio calculations are 28
calculated by dividing the numerator by the denominator as 29
follows: 30
(a) The numerator shall be the amount spent on patient 31
care and shall include: 32
(i) The amount expended for clinical dental 33
services which are services within the code on dental procedures 34
and nomenclature, provided to enrollees which includes payments 35
under capitation contracts with dental providers, whose services 36
are covered by the contract for dental clinical services or 37
supplies covered by the contract; provided, any overpayment that 38
has already been received from providers shall not be reported as 39
a paid claim. Overpayment recoveries received from providers shall 40
be deducted from incurred claim amounts; 41
(ii) Unpaid claim reserves; and 42
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(iii) Claim payments recovered by insurers from 43
providers or enrollees using utilization management efforts, 44
deducted from claim amounts. 45
(b) Calculation of the numerator shall not include: 46
(i) All administrative costs, including, but not 47
limited to, infrastructure, personnel costs or broker payments; 48
(ii) Amounts paid to third-party vendors for 49
secondary network savings; 50
(iii) Amounts paid to third-party vendors for 51
network development, administrative fees, claims processing and 52
utilization management; and 53
(iv) Amounts paid to a provider for professional 54
or administrative services that do not represent compensation or 55
reimbursement for covered services to an enrollee, including, but 56
not limited to, dental record copying costs, attorney fees, 57
subrogation vendor fees, compensation to paraprofessionals, 58
janitors, quality assurance analysts, administrative supervisors, 59
secretaries to dental personnel and dental record clerks. 60
(c) The denominator is the total amount of earned 61
premium revenue except for federal and state taxes, licensing and 62
regulatory fees paid, and any other payments required by federal 63
law. 64
(2) In order to provide transparency of patient premium 65
expenditures for dental healthcare services, all carriers that 66
renew, deliver, or issue a dental healthcare service plan in this 67
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state shall file a dental loss ratio annual report for the 68
preceding calendar year to the commissioner no later than June 30, 69
2027, and annually thereafter, no later than June 30th of each 70
calendar year. 71
(3) The annual report shall comply with all of the 72
following: 73
(a) Be organized by market and product type. 74
(b) Contain the same information as required by the 75
2013 federal Centers for Medicare & Medicaid Services Medical Loss 76
Ratio Annual Reporting Form (CMS-10418). 77
(c) Provide the number of enrollees, the plan 78
cost-sharing, deductible amounts, the annual maximum coverage 79
limit, and the number of enrollees who meet or exceed the annual 80
coverage limit. 81
(4) Any terms used in the data loss ratio annual report 82
shall have the same meaning as used in the federal Public Health 83
Service Act, 42 U.S.C. 300gg-18 and Part 158 of Title 45 of the 84
Code of Federal Regulations. 85
(5) If the commissioner deems it necessary that additional 86
information is needed to verify a plan's representation of its 87
data, the commissioner shall provide a written notice to the 88
carrier that requests this additional information. The carrier 89
shall have thirty (30) days from receipt of the notice to submit 90
the additional information. 91
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ST: "Creating Transparency and Accountability
in Dental Services Act"; enact.
(6) The data loss ratio annual report filed with the 92
commissioner shall be made available to the public no later than 93
December 1, 2027, and annually thereafter, no later than December 94
1 of each calendar year. The commissioner shall post the dental 95
loss ratio in a searchable format on the department's website. 96
(7) The commissioner shall file a report on the data 97
collected pursuant to this section with both the Senate and House 98
Insurance Committees no later than December 1, 2027, and annually 99
thereafter, no later than December 1 of each subsequent calendar 100
year. 101
(8) The provisions of this act shall not apply to benefit 102
plans under Medicaid, the Mississippi Children's Health Insurance 103
Program, or other state-sponsored plans. 104
SECTION 4. This act shall take effect and be in force from 105
and after July 1, 2026. 106