SB 5351, WSDA’s bill to reform the broken dental benefits system in Washington, was introduced on Thursday, January 16. This bill has strong bipartisan support from across the political spectrum, including sponsorship from the majority of members of the Senate Health Care Committee.

SB 5351 contains a number of important provisions, including:

• Requiring all dental insurance plans operating in Washington to maintain a dental loss ratio of at least 85%. This means that all plans would have to pay out at least 85% of the premium dollars they collect in the form of patient benefits. Those unable to meet the threshold would be required to rebate a pro-rated share of the premiums they collect.
• Requiring that insurance companies maintain parity in what they reimburse for care provided by dentists regardless of whether they are members of the carrier's network or not. Many dental carriers already maintain parity so this language will not impact their current practice. The state's largest dental carrier, Delta Dental of Washington, does not maintain parity — as we highlighted in this message last week.
• Prohibiting insurance company rules that deny reimbursement payments for covered procedures simply because they are performed on the same day as another covered procedure. When there is no medical rationale for delaying care, insurance policies like this create entirely avoidable risks for patients.

We will continue to refine specific bill language in response to helpful feedback we received through discussions with staff at the Office of the Insurance Commissioner (OIC). We are encouraged that Insurance Commissioner Kuderer and her staff are taking such an active interest in the legislation, and that it has already garnered strong bipartisan support.

A companion bill to SB 5351 will be filed in the House soon.

The legislative process is a marathon, not a sprint. There are many procedural hurdles that must be cleared. Opponents of the bill will mount strong opposition. Along the way, we will need help from you, all Washington dentists, and all dental team members and patients interested in advocating for these important reforms. Stay tuned for specific calls to action during the Legislature's deliberations. To sign up for text alerts, text the word WSDA to the number 52886.

Thank you again for everything you do to enhance oral health in Washington.