I 

114TH CONGRESS 

1ST SESSION H. R. 1677 

To amend the Employee Retirement Income Security Act of 1974 to ensure 

health care coverage value and transparency for dental benefits under 

group health plans. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 26, 2015 

Mr. GOSAR (for himself, Mr. SALMON, Mr. TIPTON, Mr. BABIN, Mr. KELLY

of Pennsylvania, Mr. MEADOWS, Mr. AMODEI, Mr. HECK of Nevada, Mr. 

JONES, Mr. YOUNG of Alaska, Mr. YOHO, Mr. FARR, Mr. DAVID SCOTT

of Georgia, Mr. BLUMENAUER, Mr. CLAY, Mr. ROE of Tennessee, Mr. 

STIVERS, Mr. HUFFMAN, Ms. LOFGREN, and Mr. GRIFFITH) introduced 

the following bill; which was referred to the Committee on Education and 

the Workforce 

A BILL 

To amend the Employee Retirement Income Security Act 

of 1974 to ensure health care coverage value and transparency for dental benefits under group health plans. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Dental Insurance Fair5 ness Act of 2015’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) Dental coverage helps approximately 173 

2 million Americans get the dental care that is vital to 

3 ensuring good oral and overall health. 

4 (2) The Dental Insurance Fairness Act of 2015 

5 will help consumers receive the full value of their 

6 dental coverage. 

7 SEC. 3. VALUE REQUIREMENTS FOR DENTAL BENEFITS. 

8 Subpart B of part 7 of subtitle B of title I of the 

9 Employee Retirement Income Security Act of 1974 (29 

10 U.S.C. 1185 et seq.) is amended by adding at the end 

11 the following: 

12 ‘‘SEC. 716. VALUE REQUIREMENTS FOR DENTAL BENEFITS. 

13 ‘‘(a) IN GENERAL.—The requirements of this section 

14 shall apply to self-insured group health plans insofar as 

15 they provide dental benefits (including, notwithstanding 

16 section 732(c)(1), self-insured limited scope dental bene17 fits (described in section 733(c)(2))). 

18 ‘‘(b) VALUE.—In order to ensure that participants 

19 and beneficiaries in a group health plan receive full value 

20 from dental benefits, the plan shall meet the following re21 quirements: 

22 ‘‘(1) UNIFORM COORDINATION OF BENEFITS.— 

23 The plan shall provide for coordination of benefits in 

24 a manner so that the plan pays the same amount re25 gardless of other coverage for such benefits so long 


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1 as the total amount paid does not exceed 100 per2 cent of the amount of the applicable claim. Such co3 ordination shall be effected consistent with such 

4 rules as the Secretary establishes, based upon simi5 lar model regulations developed by the National As6 sociation of Insurance commissioners. 

7 ‘‘(2) EQUITY FOR DENTAL PATIENTS THROUGH

8 ASSIGNMENT OF BENEFITS.—In the case of a plan 

9 that provides dental benefits through a network of 

10 providers, the plan shall permit a participant or ben11 eficiary to designate payment of dental benefits to a 

12 provider who is not participating in the network.’’. 

Æ 


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