Frequently Asked Questions

A Dental Loss Ratio sets a minimum amount that dental insurers must spend on actual healthcare services in support of patient care. Medical insurance plans are required to have a Medical Loss Ratio (MLR) of 85% for larger carriers or 80% MLR for smaller carriers. That means for every dollar a medical insurance plan receives in revenue from premiums, 85 cents or 80 cents must be spent back on patient care. No requirement exists for dental plans.

Current proposed legislation for the 2025 Minnesota legislative session requires dental plans to spend 85% of gross premium revenue on patient care.

Patients rightfully expect their dental insurance premiums to be used to support their oral health, and patients deserve visibility into how much of their premiums are paying for care. 

Dental plans are largely sold separate from medical coverage. Medical plans have consumer protections like a Medical Loss Ratio but dental plans do not. It is time to bring this important consumer protection reform that has helped consumers receive quality, accessible and more affordable care on the medical side to dental insurance.

If a dental plan does not meet the dental loss ratio contained in legislation, the dental plan must address the shortfall in a manner that benefits enrollees or beneficiaries. 

Each plan should decide the appropriate approach to meeting the ratio while always keeping the enrollee in mind. Dental plans should only increase premiums as a last resort. Keep in mind that if premiums increase, the return value of the dental benefit also increases. The State of Minnesota would also review premium rate increases as it currently does under Minnesota law. 

Yes. In 2022, Massachusetts voters overwhelmingly adopted a dental loss ratio of 83%. Nevada requires a ratio of at least 75% ratio while New Mexico has requires a ratio of 65%. Other states have passed laws requiring public reporting of dental loss ratio data and may require a ratio percentage in the future.  At least a dozen states have introduced legislation establishing a ratio requirement and more are expected to file legislation in 2025.

Download the flier on the Public Resources page and post it in your dental practice. Encourage patients to educate themselves on the importance of a dental loss ratio. Do not forget to contact your legislator and ask that they support the bill. 

You can help support and advance a dental loss ratio requirement in Minnesota by acting now! Contact your legislators directly and ask for their support.