§ 514C.3B — Dental coverage — fee schedules

Iowa § 514C.3B

• Jurisdiction: Iowa
• Title XIII: COMMERCE
• Ch. 514C: SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES

Text

1. A contract between a dental plan and a dentist for the provision of services to covered
individuals under the plan shall not require that a dentist provide services to those covered
individuals at a fee set by the dental plan unless such services are covered services under the
dental plan.
2. A person or entity providing third-party administrator services shall not make available
any dentists in its dentist network to a dental plan that sets fees for dental services that are
not covered services.
3. For the purposes of this section:
a. “Covered services” means services reimbursed under the dental plan.
b. “Dental plan” means any policy or contract of insurance which provides for coverage
of dental services not in connection with a medical plan that provides for the coverage of
medical services.
4. Nothing in this section shall be construed as limiting the ability of an insurer or a
third-party administrator to restrict any of the following as they relate to covered services:
a. Balance billing.
b. Waiting periods.
c. Frequency limitations.
d. Deductibles.
e. Maximum annual benefits.