State Legislature to Consider Key Consumer Protections in Dental Bill of Rights

Connecticut by the Numbers

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Connecticut residents are urging members of the state House and Senate to approve a series of key consumer protections in the legislative session that begins next month. A resounding 95% of Connecticut residents believe it is important for the state to develop a Dental Bill of Rights that would “establish clear, simple and transparent” dental insurance processes, according to a new statewide public opinion survey.

That reflects an increase from 92% in a similar survey a year ago. Of those voicing support for a Dental Bill of Rights in the latest survey, 42% say it is “extremely important” and another 32% indicate that it is “very important” for the state legislature to approve.

Four proposals are being advocated by the Connecticut State Dental Association this year, in urging approval of additional components of a comprehensive Dental Bill of Rights, building on some elements approved in recent years.

They would cap the percentage of premiums that could be used for administrative costs rather than patient care, make it more difficult to insurers to deny or reduce patient coverage for dental procedures that had been previously authorized, make it easier for dentists to inform patients about their dental insurance coverage on specific procedures, and limit the time in which an insurance company can retroactively deny coverage, which leads to unexpected bills to dentists and patients.

  • The first proposal would make it more difficult for dental insurers to deny or reduce coverage for dental procedures that had been previously authorized. Many people are surprised that current law allows this to occur. In the statewide survey, an overwhelming 98% of Connecticut residents said that ending this practice is important to them, including 53% who indicate it is “extremely important.”
  • Connecticut would be among the first states to ensure that a certain percentage of premiums paid by patients go to dental care, rather than insurance company administrative costs. Such requirements already exist for medical care, but not yet for dental care. The survey found that 94% of state residents believe Connecticut should require dental insurance companies report the percentage of the premiums they collect that is spent on dental care and the percentage that goes to administrative costs. In addition, 91% support the state imposing a limit on the percentage of the dental insurance premium that can be used for administrative costs.
  • 24 states have passed consumer protection laws that respond to an all-too-common practice – when insurance companies require a dentist to pay back to the insurer a claim the insurance company has already paid, if the insurer discovers they had done so mistakenly. There’s no time limit for the Retroactive Denial of Coverage - it could be years later, surprising the dentist and the patient with an unexpected bill. Many states have imposed a reasonable limit – usually between 12 and 18 months.
  • 94% of Connecticut residents surveyed indicated that adding a code or language on dental insurance cards so that dental offices will know what is covered under an individual patient’s insurance plan is an important reform. It would enable dentists to share that information with their patients as they discuss specific dental procedures. More than 7 in 10 survey participants said such a reform is “extremely important” or “very important,” with increased numbers in both categories from an identical question asked in 2020.

“Connecticut consumers expect and deserve these protections, and we’re proud to stand with our patients in advocating for these important reforms,” said Annemarie "Mimi" DeLessio-Matta, DMD, president of the CSDA. “These are common sense, pro-consumer protections that focus on predictability, transparency and public health. We look forward to working with our legislators in the upcoming session to achieve these important and extremely popular reforms.”

Dental insurance reform, as in the Dental Bill of Rights, will help to ensure that more of the premium dollars patients pay will go to care provided, rather than complicated and unpredictable administrative fees. And it will make it easier for Connecticut residents to act on staying healthy: by regularly seeing their dentist, making coverage more certain, and ending unexpected bills.

Among the main barriers people face in getting needed dental care is affordability, according to the Health Policy Institute. Delaying dental work can lead to more serious dental issues, and can potentially impact overall health, according to the Connecticut State Dental Association, which commissioned the statewide survey, conducted during November 2021 by Connecticut-based Spectrum Associates Market Research.

Some Residents Put Off Dental Visits Due to COVID; Uncertainty about Insurance Coverage, Costs Are Contributing Factors

The Connecticut survey also found that largely due to COVID-19, the percentage of state residents that have not been to see a dentist recently is more than twice what is true in a typical year, and one-third of those who have not been to the dentist in 2020 or 2021 had issues with their teeth or gums but decided not to go to the dentist due to the pandemic.

Only 13% of the survey respondents said they do not visit the dentist in a typical year. In 2020 that percentage was 30%; in 2021 it was 28%. Among those who said they don’t see a dentist in a typical year, the reasons cited most often related to cost: 17% were concerned about ending up with a costly bill, 15% don’t have dental insurance, and 8% don’t know what their dental insurance would cover. Those concerns are addressed in the proposed Dental Bill of Rights legislation.

Of those who did have a dental visit amidst the pandemic, 95% indicated they were comfortable doing so. Only 5% of survey respondents said they were not comfortable, down from 7% in the previous year.

Fewer than one in five respondents changed their dentist of dental office during 2020 or 2021. Of those who did, the two most-cited reasons were either because they had changed dental insurance, or because they had “heard great things about their new dentist.”

“There’s more to do in 2022,” CSDA President DeLessio-Matta said. “The public opinion survey not only demonstrated the broad public support for these consumer protections, it reflected the importance of responding to very legitimate consumer concerns about their dental insurance coverage and costs. Dentists and patients are on the same page – we’re hoping legislators will respond.”

The public opinion survey included 400 Connecticut residents age 25 and older; half were male and half were female. The age ranges of respondents were consistent with Connecticut’s age demographics, and more than 9 in 10 indicated they currently have, or have had, dental insurance. The survey is at a 95% confidence level with a +/- 5% margin of error.

The Connecticut State Dental Association (CSDA) is a statewide, professional membership organization representing Connecticut licensed dentists. CSDA members are committed to protecting the health and well-being of people of all ages. CSDA has a statewide membership of approximately 1,800 actively practicing, licensed dentists in Connecticut.

The CSDA supports legislation that protects the high quality of dental care that Connecticut residents receive, and sponsors statewide public outreach programs that highlight the importance of good dental health for people of all ages. Learn more at www.csda.com. The 2022 legislative session begins on February 9 and adjourns on May 4.

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