§ 3809. Schedule of charges.
186 words·~1 min read·
/de/title-18/chapter-38-dental-plan-organization-act/3809·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)No schedule of charges for enrollee coverage for dental services, or amendment thereto, may be used by a dental plan organization until a copy of such schedule, or amendment thereto, has been filed with the Commissioner. The Commissioner may disapprove the schedule of charges at any time if he or she finds that the charges are excessive, inadequate or unfairly discriminatory. If the Commissioner disapproves the schedule of charges he or she shall notify the dental plan organization within 5 days of the day of disapproval and specify in the notice the reason for his or her disapproval. A hearing shall be granted within 20 days after a request in writing by the filer. It shall be unlawful for any dental plan organization whose schedule of charges has been disapproved to effect any contract or issue any subscription certificate which uses the disapproved schedule of charges until a revised schedule of charges has been filed.
(b)Charges shall be established in accordance with actuarial principles, but charges applicable to an enrollee shall not be individually determined based on the status of his or her health.