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Massachusetts’ Minimum Medical Loss Ratio for Dental Plans

Interviewing dental plans and brokers to assess early impacts
  • Client
    National Association of Dental Plans
  • Dates
    2024

Problem

Massachusetts was among the first states to adopt minimum medical loss ratios for dental insurance plans.

Minimum medical loss ratios (MLRs) are regulations that require health insurance providers to spend a certain percentage of their premium revenue on medical claims and quality improvement activities, as opposed to administrative costs and profits. The Affordable Care Act (ACA) set minimum MLRs for health insurance plans at 80 percent for individual and small group markets and 85 percent for large group markets. Because the ACA’s MLR requirements don’t apply to stand-alone dental plans, several states have passed legislation to establish their own minimum dental MLRs.

In 2022, Massachusetts voters passed a ballot measure imposing a dental plan MLR of 83 percent. After the law was enacted, research on its early impacts was needed to understand its consequences and inform similar legislation in other states.

Solution

NORC conducted interviews with dental plans and brokers to assess the initial impact of Massachusetts’ MLR.

NORC interviewed six dental brokers and seven dental plan representatives about their perspectives on Massachusetts’ MLR law from March to July 2024, shortly after its implementation. Our research is therefore mainly limited to early impacts, although it does contain several experience-based predictions. During our interviews, study participants shared their own perspectives, including their perceptions of what dental providers, employers, and consumers think about the new regulations.

We then developed a report summarizing the results and shared our findings at the National Association of Dental Plan's (NADP) September 2024 CONVERGE conference in Minneapolis, Minnesota.

Result

Brokers and plan representatives shared early impacts, potential future impacts, and perspectives on the new dental MLR.

Brokers and plan representatives spoke about the early impacts of the new dental MLR in Massachusetts, including market disruption as some plans leave market segments or the entire Massachusetts market, decreased broker compensation, and general uncertainty about the law’s effects. Interview participants from both groups expressed frustration with using a ballot initiative for law-making, noting that this law will lead to unintended consequences such as consumer price increases and reduced dental care access in the future, particularly for small businesses and their employees. 

Project Leads

Key Project Staff

Millie Dibble
Manager

Nina Regenold
Manager

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