Chapter 695D - PLANS FOR DENTAL CARE
- Section 695D.010 - Definitions
- Section 695D.012 - "Administrator" defined
- Section 695D.020 - "Commissioner" defined
- Section 695D.030 - "Dental care" defined
- Section 695D.040 - "Dentist" defined
- Section 695D.050 - "Member" defined
- Section 695D.060 - "Organization for dental care" defined
- Section 695D.070 - "Plan for dental care" defined
- Section 695D.080 - "Policy" defined
- Section 695D.090 - Applicability of title to organizations for dental care; applicability of chapter
- Section 695D.095 - Applicability of chapter and certain other provisions to organizations for dental care
- Section 695D.100 - Regulations
- Section 695D.102 - Summary of coverage: Contents of disclosure; approval by Commissioner; regulations
- Section 695D.104 - Summary of coverage: Copy required to be provided to group policyholder before issuance of policy; organization prohibited from offering plan unless disclosure approved by Commissioner
- Section 695D.110 - Certificate of authority: Required for establishing, operating, acting as administrator of, selling or offering to sell plan for dental care
- Section 695D.120 - Certificate of authority: Application
- Section 695D.130 - Certificate of authority: Issuance; fees
- Section 695D.140 - Certificate of authority: Notice of change of information; application for amendment; fee; approval
- Section 695D.150 - Certificate of authority: Expiration; renewal; fees
- Section 695D.153 - Capital account: Minimum amount; requirements
- Section 695D.157 - Hazardous financial condition: Regulations; determination; powers of Commissioner
- Section 695D.160 - Composition of board of directors for organization for dental care that is corporation
- Section 695D.170 - Bond or deposit: Required; amount; creation of Fund for Bonds of Organizations for Dental Care; judgment as lien; disposition upon dissolution, liquidation or other termination of organization
- Section 695D.180 - Requirements concerning bond
- Section 695D.190 - Certain persons in organization for dental care in fiduciary relationship to members; dentist subject to disciplinary action for breaches of fiduciary or contractual obligations
- Section 695D.200 - Policy: Review by prospective members at meeting; provision of copy to members; approval by Commissioner; form and contents; notice of change
- Section 695D.203 - Group plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer
- Section 695D.205 - Copayments and deductibles: Reasonableness; approval of Commissioner; regulations
- Section 695D.210 - Policy covering dependent of member required to include coverage for member's newly born and adopted children and children placed with member for adoption to same extent as other dependents
- Section 695D.215 - Claims: Approval or denial; request for additional information; payment; interest on unpaid claim
- Section 695D.2153 - Claims: Organization for dental care or administrator prohibited from denying claim for which prior authorization has been granted; exceptions
- Section 695D.2157 - Recovery of overpayments: Notice; procedures for challenging attempted recovery; limitation of period for recovery; exception
- Section 695D.216 - Required provision concerning coverage for services provided through telehealth
- Section 695D.217 - Organization for dental care prohibited from denying coverage solely because person was victim of domestic violence
- Section 695D.219 - Organization for dental care prohibited from denying coverage solely because applicant or member was intoxicated or under the influence of controlled substance; exceptions
- Section 695D.220 - Licensing of agents
- Section 695D.225 - Contracts between organization for dental care and dentist: Modification; submission of schedule of payments upon request; exceptions
- Section 695D.227 - Prohibitions related to setting of fees by plan or organization for dental care other than covered services to members
- Section 695D.230 - Advertising or materials used to enroll or solicit members: Approval of Commissioner; penalties
- Section 695D.240 - Limitation on use of charges or premiums for marketing and administrative expenses; regulations
- Section 695D.250 - Reserves: Maintenance; exception; held in fiduciary capacity; deposit; penalty for diversion or appropriation; regulations
- Section 695D.260 - Annual report; financial statement; quarterly statement; administrative penalty for failure to file timely report or statement; extension of time; payment of premium tax and filing fee
- Section 695D.270 - Examination by Commissioner
- Section 695D.280 - Rehabilitation, liquidation or conservation: Conduct
- Section 695D.290 - Trade practices and frauds: Applicability of provisions to organizations for dental care
- Section 695D.300 - Disciplinary action: Grounds; penalties
- Section 695D.310 - Disciplinary or other action: Notice; hearing; order