1. A contract between a dental plan and a dentist for the provision of services to covered individuals under the plan shall not require that a dentist provide services to those covered individuals at a fee set by the dental plan unless such services are covered services under the dental plan.
2. A person or entity providing third-party administrator services shall not make available any dentists in its dentist network to a dental plan that sets fees for dental services that are not covered services.
3. For the purposes of this section:
a. “Covered services” means services reimbursed under the dental plan.
b. “Dental plan” means any policy or contract of insurance which provides for coverage of dental services not in connection with a medical plan that provides for the coverage of medical services.
4. Nothing in this section shall be construed as limiting the ability of an insurer or a third-party administrator to restrict any of the following as they relate to covered services:
a. Balance billing.
b. Waiting periods.
c. Frequency limitations.
d. Deductibles.
e. Maximum annual benefits. 2010 Acts, ch 1179, §1 \n
Notes of Decisions
Iowa Dental Ass'n v. Iowa Ins. Div. & Iowa Ins. Comm'r, 831 N.W.2d 138 (Iowa 2013).
· cites it 53× “See Iowa Code § 514C.3B (2011). Under the Commissioner’s interpretation of that law, an insurer may limit the maximum fees charged by dentists for services that are generally included in the insurer’s dental plan, even though they are not actually reimbursed by the insurer…”
Robert F. Colwell, Jr. v. Iowa Dep't of Human Servs., 923 N.W.2d 225 (Iowa 2019).
· cites it 11× “See Iowa Code § 514C.3B. The Code defines a ''dental plan'' to mean "any policy or contract of insurance which provides for coverage of dental services not in connection with a medical plan that provides for the coverage of medical services.”
— Iowa Code § 514C.3B(1) — 1 case
Iowa Dental Ass'n v. Iowa Ins. Div. & Iowa Ins. Comm'r, 831 N.W.2d 138 (Iowa 2013).
“See Iowa Code § 514C.3B (2011). Under the Commissioner’s interpretation of that law, an insurer may limit the maximum fees charged by dentists for services that are generally included in the insurer’s dental plan, even though they are not actually reimbursed by the insurer…”
— Iowa Code § 514C.3B(3) — 2 cases
Robert F. Colwell, Jr. v. Iowa Dep't of Human Servs., 923 N.W.2d 225 (Iowa 2019).
“See Iowa Code § 514C.3B. The Code defines a ''dental plan'' to mean "any policy or contract of insurance which provides for coverage of dental services not in connection with a medical plan that provides for the coverage of medical services.”
Iowa Dental Ass'n v. Iowa Ins. Div. & Iowa Ins. Comm'r, 831 N.W.2d 138 (Iowa 2013).
“See Iowa Code § 514C.3B (2011). Under the Commissioner’s interpretation of that law, an insurer may limit the maximum fees charged by dentists for services that are generally included in the insurer’s dental plan, even though they are not actually reimbursed by the insurer…”
— Iowa Code § 514C.3B(3)(a) — 1 case
Iowa Dental Ass'n v. Iowa Ins. Div. & Iowa Ins. Comm'r, 831 N.W.2d 138 (Iowa 2013).
“See Iowa Code § 514C.3B (2011). Under the Commissioner’s interpretation of that law, an insurer may limit the maximum fees charged by dentists for services that are generally included in the insurer’s dental plan, even though they are not actually reimbursed by the insurer…”
— Iowa Code § 514C.3B(3)(b) — 2 cases
Iowa Dental Ass'n v. Iowa Ins. Div. & Iowa Ins. Comm'r, 831 N.W.2d 138 (Iowa 2013).
“See Iowa Code § 514C.3B (2011). Under the Commissioner’s interpretation of that law, an insurer may limit the maximum fees charged by dentists for services that are generally included in the insurer’s dental plan, even though they are not actually reimbursed by the insurer…”
— Iowa Code § 514C.3B(4) — 1 case
Iowa Dental Ass'n v. Iowa Ins. Div. & Iowa Ins. Comm'r, 831 N.W.2d 138 (Iowa 2013).
“See Iowa Code § 514C.3B (2011). Under the Commissioner’s interpretation of that law, an insurer may limit the maximum fees charged by dentists for services that are generally included in the insurer’s dental plan, even though they are not actually reimbursed by the insurer…”
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