Vermont Statutes Title 8 Sec. 4122
Terms Used In Vermont Statutes Title 8 Sec. 4122
- Contract: A legal written agreement that becomes binding when signed.
- Covered individual: means an individual covered under a dental insurance plan or a health insurance plan. See
- Dental insurer: means any health or dental insurance company, including a nonprofit dental service corporation, that offers a dental insurance plan for sale. See
- Dentist: means an individual licensed to practice dentistry under 26 Vt. See
- Fees: shall mean earnings due for official services, aside from salaries or per diem compensation. See
- Person: shall include any natural person, corporation, municipality, the State of Vermont or any department, agency, or subdivision of the State, and any partnership, unincorporated association, or other legal entity. See
§ 4122. Fees for covered dental services
(a) No dental insurer, health insurer, or other similar entity that covers dental services and is subject to regulation by the Department of Financial Regulation, and no contract or participating provider agreement with a dentist, shall require, directly or indirectly, that a dentist who is a participating provider provide dental services to a covered individual at a fee set by, or subject to the approval of, the insurer or other regulated entity unless the dental services are covered services.
(b) No person providing third-party administrator services shall make available to any customers a plan that sets dental fees for providers in its provider network for any dental services other than covered services.
(c) Fees for covered services shall be set in good faith and shall not be nominal.
(d) The Commissioner of Financial Regulation shall enforce the provisions of this section pursuant to the Commissioner’s authority under this title. (Added 2021, No. 25, § 31, eff. Jan. 1, 2022.)