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MontanaSB 33569th Legislature, Regular Session (2025)SenateWALLET

Generally revise laws related to dental insurance

Sponsored By: Greg Hertz (Republican)

Signed by Governor

Health Care ServicesHealthInsurance

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 4 benefits, 0 costs, 0 mixed.

Rebates or lower premiums when plans underspend

Beginning June 1, 2025, the commissioner averages each plan’s dental loss ratio over three years by market segment. Plans more than one standard deviation below the segment average are outliers, unless within three percentage points of the average. The commissioner can investigate outliers and require rebates or next‑year premium cuts. Policyholder rebates are due by August 1 of the next fiscal year; premium credits are allowed. If a plan is an outlier two years in a row, the commissioner must set a market minimum loss ratio, effective no sooner than 42 months after the first outlier finding. The commissioner may also flag insurers with rate hikes above the dental services CPI.

Annual public reports on dental plans

Beginning June 1, 2025, dental insurers must file a dental loss ratio report by March 1 each year. Reports list enrollees, cost sharing, deductibles, annual maximums, and how many people hit the maximum. The commissioner publishes the data in a searchable format by January 1 of the following year. Insurers must respond to information requests within 30 days; extensions may be granted for good cause. The commissioner reports to the Economic Affairs Interim Committee every two years.

How dental plans must count care spending

Beginning June 1, 2025, the dental loss ratio is the percent of premium spent on patient care. The numerator is clinical dental services, allowed quality-improvement activities, and other incurred claims. The denominator is premium revenue minus taxes, fees, nonprofit community benefit payments, and other federally required payments. Quality-improvement spending counted cannot exceed 5% of net premium revenue. Overhead and administrative costs are excluded from the numerator.

Which dental plans these rules cover

The law creates the Montana Dental Insurance Transparency and Accountability Act. It covers standalone individual and group dental policies sold, issued, or renewed for Montana residents. It does not cover dental benefits embedded in Affordable Care Act health plans. It does not cover dental care paid by Medicaid or Healthy Montana Kids. The act takes effect June 1, 2025. These rules apply to dental policies issued or renewed on or after January 1, 2026.

Sponsors & Cosponsors

Sponsor

  • Greg Hertz

    Republican • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 352 • No: 46

Senate vote • 4/18/2025

Do Pass

Yes: 46 • No: 4

Senate vote • 4/17/2025

Do Pass

Yes: 49 • No: 0

House vote • 4/11/2025

Do Concur

Yes: 99 • No: 1

House vote • 4/11/2025

Do Concur

Yes: 99 • No: 0

Senate vote • 3/3/2025

Do Pass

Yes: 28 • No: 22

Senate vote • 3/1/2025

Do Pass

Yes: 31 • No: 19

Actions Timeline

  1. Chapter Number Assigned

    5/16/2025Senate

  2. Signed by Governor

    5/13/2025Senate

  3. Transmitted to Governor

    5/5/2025Senate

  4. Signed by Speaker

    5/5/2025House

  5. Signed by President

    4/29/2025Senate

  6. Returned from Enrolling

    4/24/2025Senate

  7. Sent to Enrolling

    4/22/2025Senate

  8. 3rd Reading House Amendments

    4/18/2025Senate

  9. 2nd Reading House Amendments

    4/17/2025Senate

  10. Returned to Senate with Amendments

    4/11/2025House

  11. 3rd Reading

    4/11/2025House

  12. 2nd Reading

    4/11/2025House

  13. Revised Fiscal Note Requested

    4/10/2025Senate

  14. Committee Report

    4/9/2025House

  15. Committee Executive Action

    4/9/2025House

  16. Hearing

    3/6/2025House

  17. 1st Reading

    3/4/2025House

  18. Referred to Committee

    3/4/2025House

  19. Transmitted to House

    3/3/2025Senate

  20. 3rd Reading

    3/3/2025Senate

  21. 2nd Reading

    3/1/2025Senate

  22. Committee Report

    2/26/2025Senate

  23. Committee Executive Action

    2/26/2025Senate

  24. Fiscal Note Printed

    2/25/2025Senate

  25. Fiscal Note Unsigned

    2/25/2025Senate

Bill Text

  • Enrolled

    4/22/2025

    PDF

  • As Amended (Version 2)

    4/9/2025

    PDF

  • Introduced

    2/17/2025

    PDF

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