Dental benefit plans; creating the Medical Loss Ratios for Dental (DLR) Health Care Services Plans Act; definitions; formula; reporting to Insurance Department; data verification; rebate calculation; rates; effective date.

Changed the act title from 'Oklahoma Medical Loss Ratios for Dental (DLR) Health Care Services Plans Act' to clarify it establishes a DLR calculation system for dental health care service plans.

Added new provisions requiring the Commissioner to identify and report outlier dental plans that fall outside one standard deviation of the average dental loss ratio.

Modified the reporting requirements to align more closely with federal Medical Loss Ratio reporting standards while maintaining state-specific oversight.

Removed the exemption clause that previously allowed certain dental plans to be exempt from the act's provisions.

Modified the definition of 'dental health care service plan' to exclude plans under Medicaid or CHIP, narrowing the scope of plans subject to the requirements.

Changed the numerator calculation to include amounts incurred for clinical dental services and quality improvement activities, while maintaining exclusions for administrative costs.

Terminology changed from 'Dental Loss Ratio' (DLR) to 'Medical Loss Ratio' (MLR) throughout the bill, aligning dental plan reporting with broader health insurance MLR standards.

Revised definition of 'earned premium' to clarify it includes all monies paid by policyholders or subscribers as a condition of receiving coverage.

Updated MLR definition to specify it measures the percentage of premium funds spent on actual patient care versus overhead costs.

Added explicit exemption language for certain dental plans from the act's provisions, limiting applicability to specialized dental benefit plans.

Added requirement for annual rebate payments for certain plan years, establishing financial return mechanisms for policyholders.

Added prohibition on certain rate establishment practices, restricting how insurers can set dental plan premiums.

Modified reporting requirements to require MLR reporting organized by market and product type using the federal CMS-10418 form.

Changed data verification process to give insurers 30 days to submit requested data before financial examination begins.

Updated bill metadata including committee designation, dates, and request numbers from oversight to policy committee version.

Updated tracking numbers from 13010 to 13201 across all pages of the committee substitute.

Corrected legal citation to include both Federal Regulations and the full U.S. Code reference (42 U.S.C., Section 1367.003) for accuracy.

Added new requirement for the Commissioner to aggregate and report dental loss ratios for each carrier, expanding data reporting obligations to include dental coverage metrics.

The entire bill text was replaced with a committee substitute version, changing the document format from 'Engrossed' to 'Proposed Committee Substitute' while preserving the original legislative intent and provisions.

Minor formatting changes were made to the bill header, including updating the sponsor information and adding committee amendment markings.

The bill's descriptive summary was updated to include additional language about amending 36 O.S. 2021, Section 7301, which relates to dental plans.

The bill's title and introductory language were updated to more clearly describe the act as the 'Oklahoma Medical Loss Ratios for Dental (DLR) Health Care Services Plans Act' and to better define terms like 'Commissioner', 'Dental carrier', 'Dental health care service plan', and 'Dental loss ratio'.

The reporting requirements were clarified to specify that carriers must file a Dental Loss Ratio (DLR) annual report with the Commissioner, organized by market and product type, and include specific data elements such as the number of enrollees, cost-sharing amounts, and annual maximum coverage limits.

The deadline for filing the DLR annual report was set to no later than May 1, 2026, and annually thereafter, with the reporting year corresponding to the preceding calendar year during which dental coverage was provided.

The Commissioner was given authority to define expenditures for clinical dental services and activities that improve dental care quality, with a cap of 5% of net premium revenue, and to make DLR data available to the public in a searchable format on the Oklahoma Insurance Department's website.

The bill's structure and formatting were updated to align with standard legislative markup practices, including changes to section numbering and the removal of certain redundant or outdated language.