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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>71148</law_id><section_number>38.2-316.2</section_number><catch_line>Dental carriers; annual actual loss ratio report</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><referred_to_by><reference>38.2-4214</reference><reference>38.2-4319</reference><reference>38.2-4509</reference></referred_to_by><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="3">Provisions Relating to Insurance Policies and Contracts</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> As used in this section:
			&#x201C;Actual loss ratio&#x201D; means, for large employer coverage issued by a <span class="dictionary">dental carrier</span>, the ratio of incurred claims and other compensation paid or due to dental providers for the reporting period to earned premiums for dental services provided under a <span class="dictionary">dental carrier</span> <span class="dictionary">contract</span> issued in the Commonwealth, excluding, for the reporting period, (i) related <span class="dictionary">state</span> and federal taxes; (ii) related licensing and regulatory fee expenses; (iii) nonprofit community benefit expenditures, which have been disclosed to the public, to support dental services and improve dental care access and quality in the Commonwealth; (iv) the amounts or related claims payments identified through <span class="dictionary">fraud</span> reduction efforts; and (v) any other related payments required under <span class="dictionary">state</span> or federal <span class="dictionary">law</span>.
			&#x201C;<span class="dictionary">Dental carrier</span>&#x201D; means (i) any carrier, as defined in &#xA7; <a class="law" title="Ethics and fairness in carrier business practices" href="/38.2-3407.15/">38.2-3407.15</a>, that offers separate or specific dental policies to large employers; (ii) any nonstock corporation that offers or administers dental services plans, as defined in &#xA7; <a class="law" title="Definitions" href="/38.2-4501/">38.2-4501</a>, to large employers; or (iii) a dental plan organization, as defined in &#xA7; <a class="law" title="Definitions" href="/38.2-6101/">38.2-6101</a>, that provides coverage to large employers.
			&#x201C;Large employer&#x201D; means, with respect to a calendar year and a plan year, an employer who employed an average of at least 51 employees on business days during the preceding calendar year and who employs at least one employee on the first day of the plan year. <a id="paragraph-256500" class="section-permalink" href="https://vacode.org/38.2-316.2/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> Beginning in 2025, each <span class="dictionary">dental carrier</span> shall annually, on or before April 30, file with the <span class="dictionary">Commission</span> a report that includes the actual loss ratio for the preceding calendar year and any such other information as the <span class="dictionary">Commission</span> may require. A <span class="dictionary">dental carrier</span> shall file such report in accordance with the format or forms prescribed by the <span class="dictionary">Commission</span>. <a id="paragraph-256501" class="section-permalink" href="https://vacode.org/38.2-316.2/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> The <span class="dictionary">Commission</span> shall annually post such reports on a dedicated link or page on the <span class="dictionary">Commission</span>&#x2019;s website on or before June 15 after receipt of such reports. <a id="paragraph-256502" class="section-permalink" href="https://vacode.org/38.2-316.2/#C"><i class="fa fa-link"/></a></p></section></text><history>2024, cc. 319, 345.</history><metadata></metadata></law>
