Identical to S 248, filed 3/11/21.
Enacts GS 58-3-245(e) to place the following responsibilities on every insurer offering a dental services benefit plan which provides a designation or rating or profiling system for dentists in the benefit plan network. Requires the insurer to utilize fair and accurate designations and rating or profiling systems and mandates disclosure to consumers and dentists the basis for the designation, rating, or profile. Adds a requirement to provide a mechanism for a dentist to challenge and correct any erroneous designation or any erroneous data or methodologies used for the designation, or rating or profiling system.
Makes technical and clarifying changes to GS 58-3-247, regarding the requirement for insurers offering health benefit plans to provide subscribers or members with an insurance identification card. Adds a new requirement for insurance identification cards to contain an indication of whether the health benefit plan is a fully insured or self-funded plan, with plans fully-insured noted by using "NCDOI" to indicate to the consumer that the Department of Insurance is able to provide assistance regarding the regulation of the plan. No longer specifically includes in the statute's scope health benefit plans of the State Health Plan for Teachers and State Employees (SHP), as the term health benefit plan is defined under GS 58-3-167 excludes the SHP. Instead enacts GS 135-48.51(7a) to subject the SHP cards to the requirements of GS 58-3-247.
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AN ACT TO REQUIRE DISCLOSURE OF THE DATA AND METHODOLOGIES USED BY DENTAL SERVICES BENEFIT PLANS BY WHICH DENTISTS ARE SUBJECT TO RATING OR PROFILING SYSTEMS OR DESIGNATIONS TO ENSURE ACCURATE, FAIR, AND USEFUL RATING OF THOSE DENTISTS AND TO INCLUDE ADDITIONAL INFORMATION ON HEALTH BENEFIT PLANS IDENTIFICATION CARDS.Intro. by K. Baker, Potts, Sasser, Lambeth.
Status: Ref to the Com on Health, if favorable, Insurance, if favorable, Rules, Calendar, and Operations of the House (House action) (Mar 25 2021)
Bill H 391 (2021-2022)Summary date: Mar 24 2021 - More information