Dental Insurance

M.G.L. c. 176X, “Dental Benefit Plans” created first in the nation standards and requires that dental carriers satisfy a statutory standard Dental Loss Ratio (DLR) – the proportion of dental claims paid in relation to premiums collected - of 83%.

What is Dental Insurance and Which Companies Offer Dental Insurance in Massachusetts?

Dental insurance pays for the cost of covered dental treatment according to the terms of the coverage.  Most traditional health coverage does not include coverage for dental services; instead, insurance companies offer dental-specific insurance policies that are separate (“stand-alone”) from traditional health insurance.  Such stand-alone products are not subject to health insurance regulations, but they are now subject to the requirements of the new law specific to dental insurance.

Below you can find a list of carriers writing dental insurance in Massachusetts.

Company	Individual	Small Group	Large Group	Group Assn
Ameritas Life Insurance Company		2-50	51+	X
Altus Dental Insurance Co, Inc	X	2-50	51+
Blue Cross and Blue Shield of Massachusetts, Inc.	X	2-50	51+
Cigna Health and Life Insurance Company		2-50	51+	X
Dental Services of Massachusetts, Inc (dba, Delta Dental of MA)	X	2-50	51+	X
Dentegra Insurance Company		2-50	51+
DSM Massachusetts Insurance Company	X	2-50	51+	X
(The) Guardian Life Insurance Company of America		25-50	51+	X
HPHC Insurance Company, Inc			51+
Humana Insurance Company	X	2-50	51+
(The) Lincoln National Life Insurance Company			51+
Metropolitan Life Insurance Company	X	2-50	51+	X
Principal Life Insurance Company		25-50	51+
Reliance Standard Insurance Company		2-50	51+	X
Renaissance Life & Health Insurance Company	X
Standard Life Insurance Company		2-50	51+	X
Starmount Life Insurance Company		2-50	51+	X
Sun Life Assurance Company		2-50	51+
UnitedHealthcare Insurance Company		2-50	51+	X
Unum Insurance Company		2-50	51+	X

Insured Dental Products Available in Massachusetts in 2026 

How is Dental Insurance Regulated?

The DOI is responsible for the licensure and financial review of all licensed insurance companies, Blue Cross and Blue Shield of Massachusetts, Inc., and Delta Dental of Massachusetts, Inc. (“Carriers”) as well as investigating complaints about dental insurance coverage, scheduling financial and market conduct examinations, and ensuring Carriers comply with regulatory standards, including those regarding the disclosure of plan benefits.  The DOI does not oversee providers, including dentists or other dental practitioners.

Applicability 

The Statute applies to all fully insured stand-alone dental benefit plans issued to individuals, group associations, and employers in Massachusetts, including dental plans issued through the Massachusetts Health Connector.

The Statute does not apply to dental plans that are issued outside of Massachusetts or through government programs (e.g., Medicaid, known as MassHealth, and plans offered through the Group Insurance Commission).  In addition, many large employers self-fund employee dental benefits, meaning that they pay the dental benefits from their own resources rather than buying an insured dental plan from a dental Carrier. These self-funded dental plans are exempt from state insurance laws, including those identified within the Statute.

How can someone know if their dental plan is subject to the Statute?

Individuals should contact their employer’s human resources representative or their dental Carrier to understand whether they are in a Massachusetts-issued insured stand-alone dental plan that is subject to the protections of the Statute.  In order to understand if the Statute applies, ask “Is my dental plan fully insured and subject to Massachusetts state insurance laws, or is it self-funded?”

Will the implementation of the Statute impact access to dental coverage?

Statutory Requirements

Carriers are required to submit the following to the DOI:

• Form and rate filings are to be submitted annually for all insured individual, group association, and employer group dental benefit plans that are issued or renewed in Massachusetts in the following calendar year.  This means the forms, including the insurance policy, used by the company and the rates that they  charge beginning in 2025 are required to meet all statutory standards.
• The rate filings will be disapproved for any of the following reasons:
  • the projected administrative expenses increase by more than the consumer price index for dental services (U.S. city average, all urban consumers, not seasonally adjusted);
  • the projected contribution-to-surplus is more than 1.9%; or
  • the projected DLR is less than 83%.

The rate filings may also be disapproved if the DOI finds that the dental benefits are unreasonable in relation to the rates charged, or if the rates are excessive, inadequate, or unfairly discriminatory.

• Forms to calculate rebates to insured individual, group association, and employer group dental benefit plans are to be submitted annually beginning with Carriers’ 2025 experience.  Rebates will be issued to individuals and groups when prior dental experience does not satisfy the statutory DLR of 83%. he DLR is calculated by dividing the combination of incurred dental claims plus certain qualified quality improvement activities by the combination of earned premium and federal and state taxes, assessments, and licensing or regulatory fees.
• Annual reports identifying detailed financial information about the Carrier’s insured dental business are to be submitted annually beginning with Carriers’ 2025 experience.  These reports will present detailed financial information about each Carrier’s insured dental business with information presented by product type and size of the covered group.

Financial Reports

Review the dental insurance annual comprehensive financial statement reports