CHARLESTON, W.Va. — A bill expected to be introduced this week could significantly change how dental insurance companies operate in West Virginia by requiring more premium dollars to be spent directly on patient care.
State Senator Jason Barrett, a Republican from Berkeley County, plans to introduce the “More for Your Smile” bill. The proposal centers on establishing a dental loss ratio requirement, which would mandate that dental insurance providers spend at least 85% of collected premiums on patient care rather than administrative costs or profits.
Supporters of the bill argue that many West Virginians are not receiving the benefits they expect despite paying monthly premiums. Hallie Mason, executive director of the West Virginia Dental Association, said patients often encounter delays, claim denials, and complex coverage limits, even when dentists recommend treatment.
“Families and employers pay premiums with the expectation that coverage will be there when it’s needed,” Mason said. “For too many West Virginians, that promise is not being fulfilled.”
According to Mason, some dental insurance companies may currently spend as little as 50% of premium revenue on patient care, with the remainder going toward overhead and profits.
If passed by the Legislature and signed by Governor Patrick Morrisey, the measure would make West Virginia the third state in the nation to enact a dental loss ratio law, following Massachusetts and North Dakota.
Proponents say the legislation would improve transparency, increase access to dental care, and ensure that patients receive greater value from their dental insurance coverage.