Iowa Dental Ass'n v. Iowa Ins. Div.
Annotate this CaseAt issue in this case was whether the Iowa Insurance Commissioner's interpretation of a recently enacted law governing dental insurance plans should be upheld. Petitioner, the Iowa Dental Association (IDA), filed with the Insurance Division a request for a declaratory order clarifying the meaning of "covered services" in the statute. The Commissioner issued a declaratory order stating that an insurer may limit the maximum fees charged by dentists for services that a generally included in the insurer's dental plan, even though they are not actually reimbursed by the insurer because of a plan restriction. The district court affirmed the Commissioner's declaratory ruling. The Supreme Court reversed, holding that the services in question did not meet the statutory definition of "covered services" because they had not been reimbursed under the dental plan. Accordingly, an insurer may only impose a maximum fee on a service when a reimbursement has been provided for that service. Remanded.
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