An Act To Expand Adult Dental Health Insurance Coverage
Maine Legislature, Session 130, LD 0441
Committee Amendment CA_A_H891 (House)
Amends: 24 MRSA §2317-B, 24-A MRSA §4320-R, 24-A MRSA §4326

COMMITTEE AMENDMENT "A" to H.P. 317, L.D. 441, "An Act To Expand 
Adult Dental Health Insurance Coverage" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'PART A 
Sec. A-1. 24 MRSA §2317-B, sub-§22, as amended by PL 2019, c. 605, §3, is 
further amended to read: 
22. Title 24-A, section 4320-M. Coverage for ab01tion services, Title 24-A, section 
4320-M; and 
Sec. A-2. 24 MRSA §2317-B, sub-§23, as enacted by PL 2019, c. 605, §4, is 
amended to read: 
23. Title 24-A, sections 2766-A and 2847-W. The prohibition on a dental benefit 
waiting period for persons under 19 years ofage, Title 24-A, sections 2766-A and 284 7-W7~ 
and 
Sec. A-3. 24 MRSA §2317-B, sub-§24 is enacted to read: 
24. Title 24-A, section 4320-R. Coverage for comprehensive dental services. Title 
24-A, section 4320-R. 
Sec. A-4. 24-A MRSA §4320-R is enacted to read: 
§4320-R. Coverage for comprehensive dental services 
1. Definition. As used in this section. unless the context otherwise indicates. 
"comprehensive dental services" means the following dental services: 
A. Acute surgical care directly related to an accident where traumatic injury has 
occurred; 
B. Oral surgical and related medical procedures not involving the dentition and 
gingiva; 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 317, L.D. 441 
C. Extraction of teeth that are severely decayed and pose a serious threat of infection 
during a major surgical procedure of the cardiovascular system or the skeletal system 
or during radiation therapy for a malignant tumor; 
D. Treatment necessary to relieve pain, eliminate infection or prevent imminent tooth 
loss; 
E. Full and partial dentures; and 
F. Other comprehensive preventive, diagnostic and restorative dental services to 
maintain good oral and overall health, prevent disease and restore oral structures to 
health and function. 
2. Required coverage. A carrier offering a health plan in this State shall provide 
coverage for comprehensive dental services. 
3. No cost sharing permitted. Notwithstanding any provision oflaw to the contrary, 
a health plan may not apply a copayment, deductible, coinsurance or other cost-sharing 
requirement for comprehensive dental services covered by this section. 
4. Coordination of benefits with dental insurance. If an emollee eligible for 
coverage under this section is also eligible for coverage under a dental insurance policy or 
contract. the insurer providing dental insurance is the prima1y payer responsible for charges 
under subsection 2 and the carrier is the secondary payer. 
Sec. A-5. Application. The requirements of this Part apply to all policies, contracts 
and certificates executed, delivered, issued for delivery, continued or renewed in this State 
on or after January 1, 2023. For purposes of this Part, all contracts are deemed to be 
renewed no later than the next yearly anniversary of the contract date. 
PARTB 
Sec. B-1. 24-A MRSA §4326, sub-§2, as enacted by PL 2019, c. 522, §1, is 
amended to read: 
2. Consumer assistance program services. The services provided by the consumer 
assistance program may include: 
A. Assisting consumers with filing complaints and appeals with a group health plan, 
health insurance carrier or independent review organization and providing information 
about the internal and external appeal and grievance processes of a group health plan, 
health insurance carrier or independent review organization; 
B. Collecting, tracking and quantifying inquiries regarding health insurance and 
problems encountered by consumers; 
C. Educating consumers on their rights and responsibilities with respect to health 
insurance coverage; 
D. Assisting consumers with obtaining health insurance coverage. including access to 
coverage for comprehensive dental services required by section 4320-R. by providing 
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information, referrals or other assistance; 
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E. Assisting with obtaining federal health insurance premium tax credits under Section 
36B of the United States Internal Revenue Code of 1986, as amended; and 
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COMMITTEE AMENDMENT •A" to H.P. 317, L.D. 441 
F. Providing information to the public about the services of the consumer assistance 
program through a comprehensive outreach program and a toll-free telephone number,l 
and 
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G. Providing information to the public about access to comprehensive dental services 
through health insurance coverage required by section 4320-R or through the 
MaineCare program, including information about dental providers providing those 
services. 
Sec. B-2. Transfers from available fiscal year 2022-23 Department of 
Professional and Financial Regulation, Other Special Revenue Funds balances 
to the Department of the Attorney· General. Notwithstanding any provision of law 
to the contrary, on October 1, 2022, the State Controller shall transfer $55,000 from 
available balances in the Bureau of Insurance, Other Special Revenue Funds account within 
the Depaitment of Professional and Financial Regulation to the Department of the Attorney 
General. 
Sec. B-3. Appropriations and allocations. The following appropriations and 
allocations are made. 
ATTORNEY GENERAL, DEPARTMENT OF THE 
Administration -Attorney General 0310 
Initiative: Provides an allocation to the Attorney General for the additional costs of adding 
dental services to its contract with a designated, nonprofit and independent health insurance 
consumer assistance entity to operate the Health Insurance Consumer Assistance Program. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
2021-22 
$0 
$0 
2022-23 
$55,000 
$55,000 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment is the minority report of the committee and replaces the bill. 
Part A of the amendment requires health insurance carriers to provide coverage for 
comprehensive dental services and prohibits a carrier from applying any cost-sharing 
requirement to those services. The definition of"comprehensive dental services" is aligned 
with the definition under the MaineCare program. Part A applies to policies and contracts 
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issued or renewed on or after January 1, • 2023. 
Part B of the amendment broadens the scope of services provided through the Health 
Insurance Consumer Assistance Program to include assistance with obtaining 
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comprehensive dental services, including information about dental providers providing 
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COMMITTEE AMENDMENT" A" to H.P. 317, L.D. 441 
these services. The amendment also provides additional funds to the consumer assistance 
program for this purpose and also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
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COMMITTEE AMENDMENT 
Approved: 03/24/22 feae 
LD441 
LR 164(02) 
An Act To Expand Adult Dental Health Insurance Coverage 
Fiscal Note for Bill as Amended by Committee Amendment tf 1 { H,,...... Jq f) 
Committee: Health Coverage, Insurance and Financial Services 
det Cost (Savings) 
General Fund 
Highway Fund 
Appropriations/ Allocations 
General Fund 
Highway Fund 
Other Special Revenue Funds 
Transfers 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
Future biennium cost increase -All Funds 
FY2021-22 
$0 
$0 
$0 
$0 
$0 
$0 
FY 2022-23 
$0 
$0 
$0 
$0 
$55,000 
$0 
Projections 
FY2023-24 
$3,226,116 
$1,135,712 
$3,226,116 
$1,135,712 
$0 
$0 
Projections 
FY2024-25 
$3,387,422 
$1,192,498 
$3,387,422 
$1,192,498 
$0 
$0 
Requiring health insurance carriers to provide coverage for comprehensive dental services without applying cost 
sharing to those services will increase General Fund costs to the State Employee Health Plan beginning in the plan 
year that starts July 1, 2023 by $3,226,116 in fiscal year 2023-24. The bill will also increase Highway Fund costs by 
$1,135,712 beginning in fiscal year 2023-24. 
• 
This bill includes an Other Special Revenue Funds allocation of $55,000 in fiscal year 2022-23 to the Department of 
the Attorney General for the additional costs of adding dental services to the contract for a Health fusurance 
Consumer Assistance Program. The allocation is funded for one year by a transfer to the Attorney General of $55,000 
from available balances within the Bureau offusurance, Other Special Revenue Funds accounts in fiscal year 2022-23 
only. 
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