Iowa Code § 514C.3B - Dental coverage — fee schedules

1. A contract between a dental plan and a dentist for the provision of services to covered individuals under the plan shall not require that a dentist provide services to those covered individuals at a fee set by the dental plan unless such services are covered services under the dental plan. 2. A person or entity providing third-party administrator services shall not make available any dentists in its dentist network to a dental plan that sets fees for dental services that are not covered services. 3. For the purposes of this section: a. “Covered services” means services reimbursed under the dental plan. b. “Dental plan” means any policy or contract of insurance which provides for coverage of dental services not in connection with a medical plan that provides for the coverage of medical services. 4. Nothing in this section shall be construed as limiting the ability of an insurer or a third-party administrator to restrict any of the following as they relate to covered services: a. Balance billing. b. Waiting periods. c. Frequency limitations. d. Deductibles. e. Maximum annual benefits. 2010 Acts, ch 1179, §1