§1165. Transparency of patient premium expenditures; dental loss ratio annual report
A. In order to provide transparency of patient premium expenditures for dental
healthcare services, all carriers that renew, deliver, or issue a dental healthcare service plan
in this state shall file a dental loss ratio annual report for the preceding calendar year to the
commissioner no later than March 1, 2025, and annually thereafter, no later than June
thirtieth of each calendar year.
B. The dental loss ratio annual report shall comply with all of the following:
(1)Be organized by market and product type.
(2)Contain the same information as required by the 2013 Centers for Medicare and
Medicaid Services Medical Loss Ratio Annual Reporting Form (CMS-10418).
(3)If not already provided for pursuant to
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§1165. Transparency of patient premium expenditures; dental loss ratio annual report
A. In order to provide transparency of patient premium expenditures for dental
healthcare services, all carriers that renew, deliver, or issue a dental healthcare service plan
in this state shall file a dental loss ratio annual report for the preceding calendar year to the
commissioner no later than March 1, 2025, and annually thereafter, no later than June
thirtieth of each calendar year.
B. The dental loss ratio annual report shall comply with all of the following:
(1) Be organized by market and product type.
(2) Contain the same information as required by the 2013 Centers for Medicare and
Medicaid Services Medical Loss Ratio Annual Reporting Form (CMS-10418).
(3) If not already provided for pursuant to Paragraph (2) of this Subsection, provide
the number of enrollees, the plan cost sharing, deductible amounts, the annual maximum
coverage limit, and the number of enrollees who meet or exceed the annual coverage limit.
C. Any terms used in the dental loss ratio annual report shall have the same meaning
as used in the Public Health Service Act, 42 U.S.C. 300gg-18 and 45 CFR Part 158.
D. If the commissioner finds that additional information is needed to verify a plan's
representation of its data, the commissioner shall provide a written notice to the carrier that
requests this additional information. The carrier shall have thirty days from receipt of the
notice to submit the additional information.
E. The dental loss ratio annual report filed with the commissioner shall be made
available to the public no later than June 30, 2025, and annually thereafter, no later than June
thirtieth of each calendar year. The commissioner shall post the dental loss ratio in a
searchable format on the department's website.
F. The commissioner shall file a report on the data collected pursuant to this Section
with the Senate Committee on Insurance and the House Committee on Insurance, and a copy
of the report shall be forwarded to the David R. Poynter Legislative Research Library as
required by R.S. 24:771 and 772, no later than June 30, 2025, and annually thereafter, no
later than June thirtieth of each calendar year.
G. The provisions of this Subpart shall not apply to plans under Medicaid or the
Louisiana Children's Health Insurance Program.