§2765-A. Coverage for services provided by dental therapist
1. Services provided by dental therapist. An insurer that issues individual dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by a dental therapist licensed under Title 32, chapter 143 when those services are covered services under the contract and when they are within the lawful scope of practice of the dental therapist.
[PL 2019, c. 388, §3 (AMD).]
2. Limits; coinsurance; deductibles. A contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
[PL 2013, c. 575, §5 (NEW); PL 2013, c. 575, §10 (AFF).]
3. Coordination of benefits with dental insurance. If an enrollee eligible for coverage under this section is eligible for coverage under a dental insurance policy or contract and a health insurance policy or contract, the insurer providing dental insurance is the primary payer responsible for charges under subsection 1 and the insurer providing individual health insurance is the secondary payer.
[PL 2013, c. 575, §5 (NEW); PL 2013, c. 575, §10 (AFF).]
4. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
[PL 2013, c. 575, §5 (NEW); PL 2013, c. 575, §10 (AFF).]
SECTION HISTORY
PL 2013, c. 575, §5 (NEW). PL 2013, c. 575, §10 (AFF). PL 2015, c. 429, §12 (AMD). PL 2019, c. 388, §3 (AMD).
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