SB403 Alabama 2011 Session

Summary

Primary Sponsor

Paul Bussman

Republican

Session

Regular Session 2011

Title

Dental services, certain health insurance policies and health maintenance organizations plans, setting fees for services not covered by the plan, prohibited

Summary

SB403 would bar health insurance plans and HMOs from forcing dentists to charge a plan-set fee for dental services that the plan does not cover.

What This Bill Does

If a dental service isn’t covered by the policy, the plan cannot require the dentist to bill at the plan’s set rate. For services that are covered, the usual terms of the plan apply. The act preserves insurers’ ability to restrict other aspects of coverage for covered services, such as balance billing, waiting periods, frequency limits, deductibles, and maximum benefits. It also defines key terms like 'covered person' and 'dental care provider' and states when the act would become law.

Who It Affects

• Covered persons and their families who have dental coverage (they may pay out-of-pocket for non-covered services at the dentist’s own rates).
• Licensed dentists who provide services to insured patients (they would not be required to accept plan-set fees for non-covered services).
• Insurance policies/plans that provide third-party payment or prepayment of health expenses (they cannot set fees for non-covered dental services).

Key Provisions

• Section 2 prohibits a policy or plan from requiring a dental care provider to deliver non-covered services at a fee set by the policy or plan.
• Section 1 defines terms: covered person, dental care provider, and insurance policies/plans providing third-party payment.
• Section 3 notes that the act does not limit insurers’ ability to restrict covered services in areas like balance billing, waiting periods, frequency limitations, deductibles, and maximum benefits.
• Section 4 sets an effective date: the act takes effect on the first day of the third month after its passage and governor’s approval.

AI-generated summary using openai/gpt-5-nano on Feb 25, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health