Ballot Question 2 – Part 2

Thursday November 03, 2022

If you did not catch Part 1 of this column last week, you can read it at www.thetowncommon.com.

As I explained last week, dental insurance is not really insurance. All plans available are dental benefit plans, intended to cover basic services. True insurance covers loss and damage. Dental insurance was set up like this in the 1970’s and has not changed. While premiums have increased, the percentage paid out by these companies has decreased significantly. Ballot Question 2 does not change the general structure of dental plans, unfortunately, but takes aim at the amount of money companies collect vs. the amount they pay out for direct patient care. 

Taken directly from the Mass.gov website:

“This proposed law would direct the Commissioner of the Massachusetts Division of Insurance to approve or disapprove the rates of dental benefit plans and would require that a dental insurance carrier meet an annual aggregate medical loss ratio for its covered dental benefit plans of 83 percent. The medical loss ratio would measure the amount of premium dollars a dental insurance carrier spends on its members’ dental expenses and quality improvements, as opposed to administrative expenses. If a carrier’s annual aggregate medical loss ratio is less than 83 percent, the carrier would be required to refund the excess premiums to its covered individuals and groups. The proposed law would allow the Commissioner to waive or adjust the refunds only if it is determined that issuing refunds would result in financial impairment for the carrier.”

Those in favor of this law say:

“A YES vote expands consumer protection laws that already exist for medical insurance companies to dental insurance companies.

A YES vote ensures better coverage and value for patients, instead of unreasonable corporate waste.

For example, according to its own 2019 Form 990, (the major dental insurance carrier in Massachusetts alone) paid executive bonuses, commissions, and payments to affiliates of $382 million, while only paying $177 million for patient care.

A YES vote would eliminate this inequity. Similar to medical insurance, this law would require dental insurance companies to allocate at least 83% of paid premiums to patient care, or refund premiums to patients to meet this standard.

Insurance companies will try to confuse voters by saying that dental insurance premiums will increase. This is false, because Section 2(d) of the law specifically disallows increases above the consumer price index without state approval.”

Those against this law will say that premiums will increase 38%. Well, that was debunked in the statement above. They will also say, “There is no law like this ballot question anywhere in the nation.” That is the point – Disruption of the current inefficient and unfair system. While this law will not fix the system completely, it will wake the rest of the country up to the inequality. 

Vote YES on Question 2. 

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

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