WAS LEG Dental Only Coverage, Payment

Updated on: Jun 10, 2025

Latest Event


  • May 2025 WAS LEG Governor Approval, Partial Veto
  • On May 12, 2025, WAS LEG reported governor partially vetoed bill, assigned Ch. 219.
  • Vetoed S. 6 emergency clause that made bill effective Jul. 1; now effective Jul. 27.
  • Document dated May 12, 2025, was added on Jun. 10, 2025, due to editorial backfill.

On Apr. 11, WAS LEG passed bill on dental only plan requirements.

  • WAS LEG passed SB 5351 (HB 1535) on dental only plan coverage, claims payments.
  • Amends WAS INS 48.43.743 (dental plans), adds new section to WAS INS 48.43.
  • Document dated Apr. 22, 2025, was received on Apr. 30 due to a fixed feed.
  • Bill Provisions
  • Dental only plans may not deny coverage because procedure performed the same day.
  • Provides other circumstances under which denial of coverage will be permitted.
  • Allows claim for reimbursement to be paid by dental only plan using credit card if any associated fees are disclosed and provider is able to select alternative with no fee.
  • Dental only plan carrier reporting data must be restricted to only Washington data.
  • Legislative History
  • On Jan. 17, 2025, bill introduced in Senate; on Mar. 10, 2025, bill passed in Senate.
  • On Mar. 12, 2025, bill introduced in House; on Apr. 11, 2025, bill passed in House.
  • On Apr. 22, 2025, bill delivered to the governor and is awaiting review and approval.
  • Effectiveness
  • Upon governor approval, SB 5351 will become effective on Jul. 27, 2025.
  • May 2025 WAS LEG Governor Approval, Partial Veto
  • On May 12, 2025, WAS LEG reported governor partially vetoed bill, assigned Ch. 219.
  • Vetoed S. 6 emergency clause that made bill effective Jul. 1; now effective Jul. 27.
  • Document dated May 12, 2025, was added on Jun. 10, 2025, due to editorial backfill.
Regulators
WAS LEG
Entity Types
Ins
Reference
Ch. 219, 5/12/2025; Bill SB5351, HB1535, 4/22/2025; Citation: WAS INS 48.43.743; WAS INS 48.43;
Functions
Claims/Accelerated Benefits; Compliance; Financial; Legal; Product Administration; Reporting
Countries
United States of America
Category
State
N/A
Products
Dental; Insurance; Insurance-Health
Rule Type
Final
Regions
Am
Rule Date
Apr 22, 2025
Effective Date
Jul 27, 2025
Rule ID
252939
Linked to
N/A
Reg. Last Update
May 12, 2025
Report Section
US Insurance