2011 North Carolina General Statutes
Chapter 58 Insurance.
Article 50 - General Accident and Health Insurance Regulations.
58-50-290. Health benefit plans or insurers contracting for provision of dental services; no limitation on fees for noncovered services.
58‑50‑290. Health benefit plans or insurers contracting for provision of dental services; no limitation on fees for noncovered services.
(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. (2010‑138, s. 1.)
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