The American Dental Association (ADA) is backing new federal legislation designed to ensure state dental insurance laws also apply to self-funded dental plans.
The Improving Dental Administration Act was introduced March 12 by Representatives Jeff Van Drew, D.M.D. (R-N.J.), and Herb Conaway, M.D. (D-N.J.). The bill aims to extend the protections of more than 360 state dental insurance and patient protection laws enacted over the past decade to patients enrolled in self-insured plans.
Currently, self-funded dental plans fall under the federal Employee Retirement Income Security Act of 1974 (ERISA). Some carriers have used ERISA to argue they are exempt from state insurance regulations, which are designed to protect patients and providers. The ADA wants to close this loophole and restore regulatory authority to the states.
“The growing number of ‘self-funded’ plans regulated by ERISA has emboldened carriers to assert they are not subject to state oversight, claiming that ERISA preemption gives them a free pass to ignore insurance laws,” said ADA President Richard Rosato, D.M.D.
“We need to fix this loophole. Patients and providers should not be left unprotected based simply on how their dental benefits are purchased.”
The legislation clarifies state authority over insurance coverage and ensures that self-funded dental plans comply with state laws. Dr. Van Drew emphasized that his experience as a dentist exposed him to the confusion and frustration caused by inconsistent insurance rules.
“Some insurance companies use a loophole in federal law to avoid the same state rules everyone else follows,” Van Drew said. “This bill closes that loophole and ensures the system protects patients and dentists, not just the insurance companies.”
Dr. Rosato added that state regulators often face uncertainty when enforcing laws on carriers administering self-funded plans. He said the bill represents a significant step toward fairness and accountability in dental coverage.
The ADA noted that the rise of self-funded plans has created confusion about which laws carriers must follow. ERISA was originally intended to protect retirement plan assets, such as 401(k), 403(b), and pension plans—not to allow carriers to bypass state insurance reforms.
“We want carriers to follow the law and stop using ERISA to ignore state insurance protections,” Rosato said.
The ADA, through the Organized Dentistry Coalition, also sent a letter thanking Representatives Van Drew and Conaway for introducing the bill. They called it “an important and timely response to the growing disconnect between state insurance protections and the realities of today’s dental coverage market.”
“We greatly appreciate your leadership in addressing longstanding inequities in dental benefits that negatively affect patients and dentists nationwide,” the letter stated.