Montana Title 33. Insurance and Insurance Companies § 33-22-2202. Definitions

Current as of January 01, 2024 | Updated by Findlaw Staff

As used in this part, the following definitions apply:

(1)(a) “Dental insurer” means an insurance company licensed to do business in the state that offers coverage for dental services, including excepted benefits as defined in 33-22-140.

(b) The term does not include health insurance coverage described in 33-22-2201(4).

(2) “Dental loss ratio” means the percentage of premium dollars spent on patient care as calculated pursuant to subsection (3)(b)(i).

(3)(a) “Medical loss ratio” is the minimum percentage of all premium funds collected by an insurer each year that must be spent on actual patient care rather than overhead costs.

(b) The dental loss ratio is calculated by dividing the numerator by the denominator, in which:

(i) the numerator is the sum of the amount incurred for clinical dental services provided to enrollees, the amount incurred on activities that improve dental care quality, and other incurred claims as defined in 45 CFR 158.140(a); and

(ii) the denominator is the total amount of premium revenue, excluding federal and state taxes, licensing and regulatory fees paid, nonprofit community benefit expenditures as defined in 45 CFR 158.162(c), and any other payments required by federal law.

Previous Part of Code Next Part of Code

Back to Chapter List

Cite this article: FindLaw.com - Montana Title 33. Insurance and Insurance Companies § 33-22-2202. Definitions - last updated January 01, 2024 | https://codes.findlaw.com/mt/title-33-insurance-and-insurance-companies/mt-code-ann-sect-33-22-2202/

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.

Was this helpful?

Welcome to FindLaw's Cases & Codes

A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw’s Learn About the Law.

Go to Learn About the Law

Did FindLaw Help You Understand This Legal Issue?

Make It a Preferred Google Search Source

Add to Google

Latest Blog Posts

Learn About The Law

Get help with your legal needs

FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.

Go to Learn About the Law

Need to Find an Attorney?

Search our directory by legal issue

Enter information in one or both fields (Required)