58-50-290. Health benefit plans or insurers contracting for provision of dental services; no limitation on fees for noncovered services or on methods of claims payment.
(a) No agreement between an insurer or an entity that writes stand-alone dental insurance and a dentist for the provision of dental services on a preferred or in-network basis to plan members or insurance subscribers in connection with coverage under a stand-alone dental plan, but not in connection with or incidental to coverage under a medical plan or health insurance policy, may require that a dentist provide services at a fee limited or set by the plan or insurer, unless the services are reimbursed as covered services under the contract.
(b) For purposes of this section, "covered services" means a service for which reimbursement is available under an insurer's policy, without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, or other limitation.
(c) No agreement between an insurer or another entity contracting for the provision of dental services and a provider of dental services shall contain restrictions on methods of claim payment in which the only acceptable payment method from the insurer or entity to the provider of the dental services is a credit card payment. (2010-138, s. 1; 2019-26, s. 1.)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 50 - General Accident and Health Insurance Regulations.
§ 58-50-1 - Waiver by insurer.
§ 58-50-15 - Conforming to statute.
§ 58-50-25 - Nurses' services.
§ 58-50-26 - Physician services provided by physician assistants.
§ 58-50-30 - Right to choose services of certain providers.
§ 58-50-35 - Notice of nonpayment of premium required before forfeiture.
§ 58-50-45 - Group health or life insurers to notify insurance fiduciaries of obligations.
§ 58-50-46 - Recodified as G.S108A-55.4 by Session Laws 2006-221, s9(a), effective January 1, 2007.
§ 58-50-56 - Insurers, preferred provider organizations, and preferred provider benefit plans.
§ 58-50-56.1 - Exclusive provider organizations, exclusive provider benefit plans.
§ 58-50-56.2 - Exclusive provider organization continuity of care.
§ 58-50-57 - Offsets against provider reimbursement for workers' compensation payments forbidden.
§ 58-50-61 - Utilization review.
§ 58-50-62 - Insurer grievance procedures.
§ 58-50-63 - Expired pursuant to Session Laws 2005-453, s3, effective July 1, 2005.
§ 58-50-65 - Certain policies of insurance not affected.
§ 58-50-70 - Punishment for violation.
§ 58-50-75 - Purpose, scope, and definitions.
§ 58-50-77 - Notice of right to external review.
§ 58-50-79 - Exhaustion of internal grievance process.
§ 58-50-80 - Standard external review.
§ 58-50-82 - Expedited external review.
§ 58-50-84 - Binding nature of external review decision.
§ 58-50-85 - Approval of independent review organizations.
§ 58-50-87 - Minimum qualifications for independent review organizations.
§ 58-50-89 - Hold harmless for Commissioner and independent review organizations.
§ 58-50-90 - External review reporting requirements.
§ 58-50-92 - Funding of external review.
§ 58-50-93 - Disclosure requirements.
§ 58-50-94 - Selection of independent review organizations.
§ 58-50-100 - Title and reference.
§ 58-50-105 - Purpose and intent.
§ 58-50-112 - Affiliated companies; HMOs.
§ 58-50-115 - Health benefit plans subject to Act.
§ 58-50-125 - Health care plans; formation; approval; offerings.
§ 58-50-130 - Required health care plan provisions.
§ 58-50-131 - Premium rates for health benefit plans; approval authority; hearing.
§ 58-50-149 - Limit on cessions to the Reinsurance Pool.
§ 58-50-150 - North Carolina Small Employer Health Reinsurance Pool.
§ 58-50-275 - Notice contact provisions.
§ 58-50-280 - Contract amendments.
§ 58-50-285 - Policies and procedures.
§ 58-50-292 - Dental provider networks; confidential business information.
§ 58-50-295 - Prohibited contract provisions related to reimbursement rates.