West Virginia Dental Association Pushes for Higher Dental Care Spending

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A recent report from the West Virginia Office of the Insurance Commissioner found that on average, only 43 cents of every premium dollar in the state goes toward patient dental care. In response, the West Virginia Dental Association is spearheading a bill that would establish an 85% patient care spending requirement for dental insurers. The goal is to ensure premium dollars are primarily used for their intended purpose - providing dental care to patients.

Why it matters

This issue highlights the growing concern over the disconnect between the premiums families and employers pay for dental insurance and the actual care patients receive. With annual benefit caps that have barely changed in decades, many West Virginians are underinsured and struggle to afford needed dental treatments. Establishing a higher patient care spending standard could help address this imbalance and improve access to affordable dental care.

The details

The West Virginia Dental Association is supporting Senate Bill 548, which would require dental insurers to spend at least 85% of premium revenue on patient care. If insurers fall short of this threshold, the difference would be returned directly to policyholders. Currently, the state's dental loss ratio data shows that on average, only 43 cents of every premium dollar goes toward patient care, with the rest going to administrative costs and overhead for insurance companies.

• The West Virginia Office of the Insurance Commissioner recently released the updated dental loss ratio data.
• The current legislative session in West Virginia provides an opportunity for lawmakers to consider the proposed Senate Bill 548.

What they’re saying

What’s next

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