AGD and Massachusetts AGD Support Question 2 Proposal

  • by AGD Staff
  • Oct 10, 2022
An important initiative is underway in Massachusetts – Question 2 — that would require dental insurance companies to spend at least 83% of premium dollars collected on dental services or refund the difference to patients. 

Massachusetts law establishes an 88% medical loss ratio (MLR) for medical insurance plans, but there is currently no MLR for dental insurance plans. An MLR is the portion of premium revenue that a healthcare insurance company spends on claims, patient care and healthcare quality for its customers. One dental insurer’s IRS 990 form documents it spent less than 60% of premium revenue on patient care and kept the remaining $383 million for administrative costs, executive salaries and profits.

“Dental insurance companies must be held accountable, and we have an opportunity to defend our profession and ensure that our patients’ premiums are used to provide them with the care they deserve,” said Gerry Feldman, DDS. “All eyes are on Massachusetts to see what happens here, and, if this initiative is successful, I believe it will have huge implications on the insurance industry and how MLRs are structured elsewhere. Everyone in the oral health community, especially general dentists, must spread the word to their patients, friends, families and communities to let them know that this ballot initiative is about increasing care and the responsibility of insurance companies to use premium dollars for patient care.”

The Massachusetts AGD endorses this dental insurance reform. AGD’s Board approved a contribution of $50,000 from its AGD Advocacy Fund to support a statewide ballot initiative in Massachusetts.

“This issue is about accountability,” said Gerald J. Botko, DMD, MAGD, AGD president. “We know that the insurance companies are threatened by this initiative, and they will do whatever it takes to protect the status quo, including spending tens of millions of dollars. That is why our Board felt it was imperative that we support this ballot initiative. We are pleased to join organizations like the Massachusetts AGD, American Dental Association, Massachusetts Dental Society, and other state and national dental groups to ensure that patient care dollars are protected.”

Through a ballot initiative, a dental insurance MLR will appear as Question 2 on the statewide ballot in the Nov. 8 election. The referendum will ensure MLRs apply to dental plans in the same way they currently apply to medical plans. This ballot initiative would make dental providers more transparent and accountable to the patients they serve. If passed, this consumer protection law is a value-guarantee that requires dental insurers to pay at least 83% of premium revenue toward patient care or refund patients the difference in premium dollars not spent.

The campaign is ongoing, and donations can be made online to support this initiative. 

AGD Members in Massachusetts: Stay connected to your local colleagues and learn more about how you can help. Help your patients, family and community members learn more about why they should vote yes on Question 2. Resource are available here.