Sec. 3. Value requirements for dental benefits
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Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185 et seq. ) is amended by adding at the end the following: The requirements of this section shall apply to self-insured group health plans insofar as they provide dental benefits (including, notwithstanding section 732(c)(1), self-insured limited scope dental benefits (described in section 733(c)(2))). In order to ensure that participants and beneficiaries in a group health plan receive full value from dental benefits, the plan shall meet the following requirements:
The plan shall provide for coordination of benefits in a manner so that the plan pays the same amount regardless of other coverage for such benefits so long as the total amount paid does not exceed 100 percent of the amount of the applicable claim. Such coordination shall be effected consistent with such rules as the Secretary establishes, based upon similar model regulations developed by the National Association of Insurance commissioners. In the case of a plan that provides dental benefits through a network of providers, the plan shall permit a participant or beneficiary to designate payment of dental benefits to a provider who is not participating in the network. .
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Sec. 3
Value requirements for dental benefits
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