Report Title:

Dental Plans; Dual Coverage

Description:

Requires health insurers and like entities who offer dental coverage to declare and execute their coordination of dental benefits policy to insureds and their counterparts.  (SD1)

THE SENATE	S.B. NO.	114
TWENTY-FIFTH LEGISLATURE, 2009		S.D. 1
STATE OF HAWAII

A BILL FOR AN ACT

RELATING TO DENTAL CARE.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  Chapter 431, article 10A, Hawaii Revised Statutes, is amended by adding a new section to part II to be appropriately designated and to read as follows:

"§431:10A‑   Coordination of dental benefits. (a)  Every policy of group or blanket disability insurance that provides coverage for dental services shall adopt coordination of benefits rules to avoid over insurance and to provide for the orderly payment of claims.  The adoption of coordination of benefits rules applies when a person is covered by two or more of the following that cover dental services:

(1) Policies, contracts, plans, and agreements with a dental service corporation authorized by chapter 423;

(2) Blanket disability insurance policies or blanket disability insurance policies regulated under chapter 431;

(3) Individual or group hospital or medical service plans regulated under chapter 432; and

(4) Policies, contracts, plans and agreements regulated under chapter 432D.

The coordination of benefits rules shall be consistent with the National Association of Insurance Commissioners Coordination of Benefits Model Regulation relating to order of benefit determinations.

(b)  A group or blanket disability insurance policy covering dental services shall declare its coordination of dental benefits policy prominently in its evidence of coverage or contract with the insured.  Each employer offering policies, contracts, plans, or agreements covering dental services shall inform its employees of any coordination of dental benefits policy."

     SECTION 2.  Chapter 432, article 1, Hawaii Revised Statutes, is amended by adding a new section to part VI to be appropriately designated and to read as follows:

"§432:1‑   Coordination of dental benefits. (a)  Every individual or group hospital or medical service plan contract that provides coverage for dental services shall adopt coordination of benefits rules to avoid over insurance and to provide for the orderly payment of claims.  The adoption of coordination of benefits rules applies when a person is covered by two or more of the following that cover dental services:

(1) Policies, contracts, plans, and agreements with a dental service corporation authorized by chapter 423;

(2) Blanket disability insurance policies or blanket disability insurance policies regulated under chapter 431;

(3) Individual or group hospital or medical service plans regulated under chapter 432; and

(4) Policies, contracts, plans and agreements regulated under chapter 432D.

The coordination of benefits rules shall be consistent with the National Association of Insurance Commissioners Coordination of Benefits Model Regulation relating to order of benefit determinations.

(b)  An individual or group hospital or medical service plan contract covering dental services shall declare its coordination of benefits policy prominently in its evidence of coverage or contract with the subscriber.  Each employer offering group hospital or medical service plan contracts covering dental services shall inform its employees of any coordination of dental benefits policy."

     SECTION 3.  Chapter 432D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432D‑   Coordination of dental benefits. (a)  Every policy, contract, plan, or agreement that provides coverage for dental services shall adopt coordination of benefits rules to avoid over insurance and to provide for the orderly payment of claims.  The adoption of coordination of benefits rules applies when a person is covered by two or more of the following that cover dental services:

(1) Policies, contracts, plans, and agreements with a dental service corporation authorized by chapter 423;

(2) Blanket disability insurance policies or blanket disability insurance policies regulated under chapter 431;

(3) Individual or group hospital or medical service plans regulated under chapter 432; and

(4) Policies, contracts, plans and agreements regulated under chapter 432D.

The coordination of benefits rules shall be consistent with the National Association of Insurance Commissioners Coordination of Benefits Model Regulation relating to order of benefit determinations.

(b)  Any policy, contract, plan, or agreement covering dental services and issued under this chapter shall declare its coordination of benefits policy prominently in its evidence of coverage or contract with the contract holder.  Each employer offering policies, contracts, plans, or agreements covering dental services shall inform its employees of any coordination of dental benefits policy."

     SECTION 4.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun, before its effective date.

     SECTION 5.  New statutory material is underscored.

     SECTION 6.  This Act shall take effect upon its approval.