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Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS

Chapter 376

Effective - 28 Aug 2013 bottom

  376.1226.  Fee schedule for services not covered under health benefit plans — definitions. — 1.  No contract between a health carrier or health benefit plan and a dentist for the provision of dental services under a dental plan shall require that the dentist provide dental services to insureds in the dental plan at a fee established by the health carrier or health benefit plan if such dental services are not covered services under the dental plan.

  2.  For purposes of this section, the following terms shall mean:

  (1)  "Covered services", services reimbursable by a health carrier or health benefit plan under an applicable dental plan, subject to such contractual limitations on benefits as may apply, including but not limited to deductibles, waiting periods, or frequency limitations;

  (2)  "Dental plan", any policy or contract of insurance which provides for coverage of dental services;

  (3)  "Health benefit plan", the same meaning as such term is defined in section 376.1350;

  (4)  "Health carrier", the same meaning as such term is defined in section 376.1350.

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(L. 2013 H.B. 315)


---- end of effective   28 Aug 2013 ----

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