20-1402.04. Contracts; dentists; covered services; definition

A. A contract, entered into or renewed on or after January 1, 2011, between a group disability insurer 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 group disability policy based on a fee set by the group disability insurer unless the services for which the fee applies is a covered service under the individual's group disability policy.

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

C. For the purposes of this section, "covered service" means a service for which any reimbursement is available under a group disability policy 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.