North Dakota passes 75% dental loss ratio

On April 18, 2025, North Dakota passed a bill that requires insurance carriers to have a 75% minimum loss ratio for all dental products. If carriers fall below this threshold, they must refund the difference in premium to meet the requirement.

Since Massachusetts passed an 83% dental loss ratio (DLR) by ballot measure in 2022, Unum has worked with industry partners to educate legislators across the country on the adverse impact DLRs have on the dental market. In the more than 20 states that have introduced DLR legislation, we have been successful in preventing these bills from passing or reaching a compromise to have dental loss ratios reported to the state Department of Insurance (DOI).

The industry worked closely with the American Dental Association (ADA) to produce a model law at the National Conference of Insurance Legislators (NCOIL), striking a balance between the dentists and the insurance industry. The model law did not mandate a specific DLR. However, many state dental associations have disregarded the model law and are pushing for DLRs that will increase costs and produce less options for consumers in the marketplace.

The passage of the 75% DLR in North Dakota is concerning, marking the first time a bill has passed through a legislature since the Massachusetts ballot initiative. While the impact to Massachusetts is still being assessed, several insurers have already exited the individual and small group markets. We will continue to work with the North Dakota DOI as they implement this law to minimize the impact on consumers and maintain a healthy market for dental insurance.