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Proposal forces dental insurers in Connecticut to spend premium payments on patient care

To make dental care more accessible, some schools are bringing dentists to students.
To make dental care more accessible, some schools are bringing dentists to students.

The Connecticut State Dental Association wants lawmakers to pass a bill to force dental insurance companies to be more transparent about where patient premiums are being spent.

Executive Director Kathlene Gerrity said health insurers have to show by law where patient premiums are going, but not when it comes to dental insurance.

Under the Affordable Care Act, at least 80% of medical premiums are required to be spent on patient care. She said estimates as little as 40% of dental premiums are going back into patient care, according to national surveys.

“So, the question really is why is there not parity between your medical insurers and your dental insurance both of them are equally important to your overall health. But, also the question is, where is the rest of that money going?” Gerrity said. “It’s going directly into the insurance companies pockets and that’s at the detriment of our patients.”

Many people have put off going to the dentist due to the pandemic, but have continued to pay their dental insurance premiums. The money from these personal or employer programs are no longer available for patient care at the end of the year, and become profit for the insurance companies.

Last year, Massachusetts voters approved a ballot question to force dental insurers in that state to be more transparent with their premium payments. In a 2021 poll, by Connecticut State Dental Association, 91% of residents supported the state limiting the percentage of dental insurance premiums that could be used for administrative costs.

The association hopes the measure in their state would “mandate that dental insurance plans that don’t meet the requirement of spending at least 85% of patient premiums — 85 cents of every dollar — on patient care will now have to refund the difference to covered individuals and groups.”

“Your dentist is a key member of [your healthcare] team,” Gerrity said. “And when dental insurance does not afford you the ability to get into the chair often enough you’re actually setting yourself up for what could be a chronic or catastrophic situation. We want to prevent that.”

“Preventative care is always better than ending up in a chronic situation obviously,” she continued.

An award-winning freelance reporter/host for WSHU, Brian lives in southeastern Connecticut and covers stories for WSHU across the Eastern side of the state.