H.R. 1677 — Introduced in House

I 114th CONGRESS 1st Session H. R. 1677 IN THE HOUSE OF REPRESENTATIVES March 26, 2015 Mr. Gosar (for himself, Mr. Salmon, Mr. Tipton, Mr. Babin, Mr. Kelly of Pennsylvania, Mr. Meadows, Mr. Amodei, Mr. Heck of Nevada, Mr. Jones, Mr. Young of Alaska, Mr. Yoho, Mr. Farr, Mr. David Scott of Georgia, Mr. Blumenauer, Mr. Clay, Mr. Roe of Tennessee, Mr. Stivers, Mr. Huffman, Ms. Lofgren, and Mr. Griffith) introduced the following bill; which was referred to the Committee on Education and the Workforce A BILL To amend the Employee Retirement Income Security Act of 1974 to ensure health care coverage value and transparency for dental benefits under group health plans. 1. Short title This Act may be cited as the Dental Insurance Fairness Act of 2015. 2. Findings Congress finds the following: (1) Dental coverage helps approximately 173 million Americans get the dental care that is vital to ensuring good oral and overall health. (2) The Dental Insurance Fairness Act of 2015 will help consumers receive the full value of their dental coverage. 3. Value requirements for dental benefits Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following: 716. Value requirements for dental benefits (a) In general The requirements of this section shall apply to self-insured group health plans insofar as they provide dental benefits (including, notwithstanding section 732(c)(1), self-insured limited scope dental benefits (described in section 733(c)(2))). (b) Value In order to ensure that participants and beneficiaries in a group health plan receive full value from dental benefits, the plan shall meet the following requirements: (1) 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 100 percent of the amount of the applicable claim. Such coordination shall be effected consistent with such rules as the Secretary establishes, based upon similar model regulations developed by the National Association of Insurance commissioners. (2) Equity for dental patients through assignment of benefits In the case of a plan that provides dental benefits through a network of providers, the plan shall permit a participant or beneficiary to designate payment of dental benefits to a provider who is not participating in the network. .