New Jersey A4166 mandates insurance carriers to provide a specific level of coverage and reimbursement for dental benefit plans.
New Jersey A4166 requires insurance carriers offering dental benefit plans to provide a level of coverage determined by the Commissioner of Banking and Insurance. The bill mandates that dental plans offer benefits actuarially equivalent to the full actuarial value of the benefits. Additionally, it requires reimbursement to providers at a level of at least 75 percent of the usual and customary charge for the service provided. The Commissioner of Banking and Insurance must develop procedures for determining the usual and customary charges for dental services on a regional basis within the State.
Included in complete analysis
- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
See what it does, who it affects, and the critical issues in plain language. Free, 30 seconds.