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History
- Referred to insurance
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:A10755
Title of bill
An act to amend the insurance law, in relation to coor- dination of benefits among dental health plans
Purpose or general idea of bill
Requires that dental. health and dental insurance plans all pay as primary providers under their plans and that this method of coordination of benefits be clearly explained to patients.
Summary of specific provisions
Bill Section 1 would add a new Section 3224-c to the Insurance Law to require that all dental benefit plans pay benefits without taking into consideration the existence of any other plan. Benefits would be coordinated with each plan paying as the primary plan, but with reimbursement capped at the total amount of the dental claim submitted. This coordination of benefits methodology must be clearly explained to all covered persons.
Bill Section 2 would provide that the law take effect January 1, 2011.
Justification
Dental benefits do not work well under existing coordi- nation of benefit rules that try to allocate benefits between primary and secondary dental benefit plans. The methodology for coordinating dental benefits that this bill would implement parallels the system used in California and codifies and makes exclusive one of the mechanisms that is permitted now under regulations of the New York State Department of Insurance - the rule that if no secondary plan can be determined, then all plans pay as primary plans. That rule is the better rule for all dental benefit plan situations. When the alternative mechanism of trying to determine which dental benefit plan is a secondary plan has been used, the result has been long delays in processing reimbursement claims and underpayment to patients. By capping the total payment at no more than the total amount of the claim submitted, the proposed legis- lation eliminates any potential for overpayment of claims, and cures the defects of underpayment and delays under the complicated process of determining if there is a secondary plan.
Prior legislative history
None,
Fiscal implications
None.
Effective date
The bill takes effect January 1, 2011.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.