Dental insurance; mandating reports by carrier; requiring certain data to be included in initial report. Effective date.

Removed the previous 'Employer Health Plan Transparency Act' which covered general health insurance plans and contract provisions.

Added new definitions for 'community benefit expenditure' and 'dental loss ratio' to standardize how dental spending is calculated and reported.

Added a requirement for dental carriers to file annual reports on dental loss ratios for the years 2024, 2025, and 2026.

Set the effective date of the new act to November 1, 2025, and established a reporting deadline of June 30 for the following year.

Directed the Insurance Department to evaluate the effectiveness of the reporting requirements and make recommendations to the public.

All specific provisions related to dental insurance, dental loss ratios, and dental community benefit expenditures were removed.

The short title and legislative purpose changed from the 'Dental Insurance Transparency Act' to the 'Employer Health Plan Transparency Act'.

New definitions were added for general terms such as 'Auditable material', 'Claims and encounter information', 'Covered service provider', 'Electronic funds transfer', and 'Health care services'.

Reporting requirements were changed from submitting dental loss ratios to providing auditable material and claims data for general health plans.

The effective date was moved from November 1, 2025, to a later date (implied by the 2026 session context), and initial reporting deadlines were adjusted to June 30, 2027.

The definition of 'dental loss ratio' was expanded to include specific items like taxes, licensing fees, fraud reduction payments, and community benefit expenditures in the numerator, while excluding overhead and administrative costs.

New definitions were added for 'large employer' (51+ employees) and 'small employer' (1-50 employees) to clarify which entities must report data.

A new requirement mandates that the Insurance Commissioner must post all submitted dental loss ratio reports on a dedicated webpage on the agency's website by September 15 of each year.

The reporting deadline was set to June 30 for annual filings, with the initial report covering calendar years 2024, 2025, and 2026 due by June 30, 2027.

The bill includes a provision for the Insurance Department to evaluate the effectiveness of public reporting and make recommendations on continuing or modifying the reporting obligation.