Missouri Dental Loss Ratio: Ensuring Your Insurance Is Working For You
More Care for Your Money
Missourians deserve dental insurance that provides real value for their money.
Missouri does not currently regulate the allocation of dental insurance premiums. Your dental insurer can spend any amount of your monthly premium dollars on marketing, overhead expenses, or even C-suite bonuses instead of improving patient care. House Bill 439 aims to require dental insurance companies to spend at least 85 percent of patient premiums on patient care, a commonsense policy that has long existed for medical insurance.
What is Dental Loss Ratio (DLR)?
Dental Loss Ratio (DLR) is a percentage that outlines the portion of dental insurance premiums that are spent on patient care, rather than overhead costs. If the DLR in Missouri is 85 percent, 85 cents of every dollar an insurance company collects must be spent on your dental care.
Establishing a DLR in Missouri would
- Increase Access to Care: The value of dental insurance has significantly decreased over time. With DLR, patients, and employers who pay insurance premiums would be guaranteed good value for their money with more opportunities for patient care added back into dental plans.
- Encourage Fair Premium Allocation: Reduces out-of-pocket costs and ensures better value for consumers.
- Hold Insurance Companies Accountable: Rebate requirements would incentivize companies to meet the 85 percent threshold and return money to patients and employers if they are overcharged for their premiums.
Without a Dental Loss Ratio, insurance companies are free to continue keeping any amount of unspent premiums for overhead rather than patient care.
How Much are Dental Insurers Currently Spending on Patient Care?
While some dental insurance companies currently meet the 85% DLR we recommend in Missouri, other insurers are spending as little as 11% on actual dental care. There is no consistency from insurer to insurer.
Can Dental Insurance Companies Operate under DLR?
In the states where data is available, many dental insurers already maintain a DLR of 85% or higher. It is possible to operate, prioritize patients, and make a profit within this standard.
Is There Precedent for DLR?
- Yes! Four states have already successfully established a Dental Loss Ratio, resulting in increased access to care and greater transparency from dental insurance companies. Similar legislation is being presented in nine other states in 2025.
- Medical Loss Ratio (MLR) has been in effect for medical insurance companies nationwide since 2011. The U.S. uninsured rate is at a historic low and health insurance companies continue to post profits in every state.
What Are the Economic Benefits of Implementing a DLR?
- Encourages Preventive Care: By ensuring that a larger share of premiums is spent on patient care, DLR encourages insurers to focus on preventive services. This can reduce the need for costly emergency treatments, leading to long-term savings for both patients and the healthcare system.
- Better Value for Employers: Requiring dental insurers to issue rebates for excess premiums spent on administrative costs ensures that employers get more value from their dental plans, improving care for employees while lowering costs.
Increased Market Competition: Currently, the dental insurance market is limited by a lack of competition, with most plans purchased through employers and premiums largely driven by price rather than value. DLR fosters an environment where insurers must offer more patient-centered plans, encouraging innovation and flexibility similar to traditional health insurance. This shift not only increases access to quality care but also ensures better value for consumers, while benefiting employers by offering more effective and affordable dental plans.
Questions about DLR? Send us a Message!
Legislators, dental professionals, and patients alike are invited to learn more about the positive impact of a Dental Loss Ratio in Missouri.
Simply complete the form or give us a call at (573) 634-3436 to chat.
