20-847. Contracts; dentists; covered services; definition

A. A contract, entered into or renewed on or after January 1, 2011, between a dental service corporation and a dentist who is licensed to practice in this state shall not require the dentist to provide services to an individual covered under a subscription contract based on a fee set by the dental service corporation unless the service for which the fee applies is a covered service under the individual's subscription contract.

B. This section does not restrict the ability of a dental service corporation to establish dental benefits for services offered by plans that are administered but not insured by the dental service corporation.

C. For the purposes of this section, "covered service" means a service for which any reimbursement is available under a subscription contract without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, exclusion or other limitation.

20-847. Contracts; dentists; covered services; definition

A. A contract, entered into or renewed on or after January 1, 2011, between a dental service corporation and a dentist who is licensed to practice in this state shall not require the dentist to provide services to an individual covered under a subscription contract based on a fee set by the dental service corporation unless the service for which the fee applies is a covered service under the individual's subscription contract.

B. This section does not restrict the ability of a dental service corporation to establish dental benefits for services offered by plans that are administered but not insured by the dental service corporation.

C. For the purposes of this section, "covered service" means a service for which any reimbursement is available under a subscription contract without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, exclusion or other limitation.