,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #agih  ,,in ,,the ,,house ,,of  
,,representatives  ,april #bf1 #bjac    
,mr4 ,gosar 7for himself1 ,mr4 ,simpson1
 ,mr4 ,andrews1 and ,mr4 ,loebsack7     
introduced the following bill2 which was
 referred to the ,committee on          
,education and the ,workforce  ,a ,,bill
  ,to amend the ,employee ,retirement   
,income ,security ,act of #aigd to      
ensure health care coverage value and   
transparency for dental benefits under  
group health plans4  #a4 ,short title   
,this ,act may be cited as the ,dental  
,insurance ,fairness ,act of #bjac4  #b4
 ,findings ,congress finds the          
following3  7#a7 ,dental coverage helps 
approximately #agc million ,americans   
get the dental care that is vital to    
ensuring good oral and overall health4  
7#b7 ,unfair practices of dental benefit
 plans hinder patients' ability to      
receive the full benefits for which they
 pay and1 in some cases1 provide the    
dental insurance industry with windfall 

profits4  7#c7 ,the ,dental ,insurance  
,fairness ,act of #bjac will help       
consumers receive the full value of     
their dental coverage4  #c4 ,value      
requirements for dental benefits        
,subpart ,b of part #g of subtitle ,b of
 title ,i of the ,employee ,retirement  
,income ,security ,act of #aigd 7#bi    
,u4,s4,c4 #aahe et seq47 is amended by  
adding at the end the following3  #gaf4 
,value requirements for dental benefits 
7a7 ,in general ,the requirements of    
this section shall apply to self-insured
 group health plans insofar as they     
provide dental benefits 7including1     
notwithstanding section #gcb7;c77#a71   
self-insured limited scope dental       
benefits 7described in section          
#gcc7;c77#b7774  7b7 ,value ,in order to
 ensure that participants and           
beneficiaries in a group health plan    
receive full value from dental benefits1
 the plan shall meet the following      
requirements3  7#a7 ,uniform            
coordination of benefits ,the plan shall

 provide for coordination of benefits in
 a manner so that the plan pays the same
 amount regardless of other coverage for
 such benefits so long as the total     
amount paid does not exceed #ajj percent
 of the amount of the applicable claim4 
,such coordination shall be effected    
consistent with such rules as the       
,secretary establishes1 based upon      
similar model regulations developed by  
the ,national ,association of ,insurance
 commissioners4  7#b7 ,equity for dental
 patients through assignment of benefits
 ,in the case of a plan that provides   
dental benefits through a network of    
providers1 the plan shall permit a      
participant or beneficiary to designate 
payment of dental benefits to a provider
 who is not participating in the        
network4  4