SB1172

THE SENATE	S.B. NO.	1172
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII

A BILL FOR AN ACT

relating to employer health care requirements.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that oral and visual health are essential components of overall health and well‑being. Regular dental and vision care can detect early signs of systemic health issues, including diabetes and cardiovascular diseases, facilitating timely interventions. Many health insurance plans, including medicaid managed care programs, do not provide comprehensive dental and vision coverage for adults. This lack of coverage leads to significant out-of-pocket expenses, deterring individuals from seeking necessary preventive and therapeutic care.

The legislature further finds that the absence of dental and vision coverage disproportionately affects low-income populations and communities of color, exacerbating health disparities. Limited access to these essential services contributes to higher incidences of untreated dental caries, periodontal disease, and vision impairments in these communities. Untreated dental and vision issues can lead to more severe health complications, resulting in increased emergency room visits and higher overall healthcare costs. Implementing comprehensive dental and vision coverage has the potential to reduce these costs by emphasizing preventive care and early treatment.

The legislature also finds that access to regular dental and vision care enhances quality of life by preventing pain, improving nutrition through proper oral function, enabling better educational and occupational performance, and reducing the risk of accidents related to visual impairments. This Act mandates all health insurers operating within the State, including medicaid managed care programs, to provide comprehensive dental and vision coverage for all enrollees, eliminating existing coverage gaps. By encouraging the utilization of preventive dental and vision services to detect and address health issues at an early stage, this Act aims to reduce the incidence of advanced diseases and associated healthcare costs.

Furthermore, the Act seeks to address and reduce health disparities by ensuring equitable access to essential dental and vision care services across all populations, particularly underserved communities. By integrating dental and vision care into standard health insurance coverage, this Act intends to improve overall health outcomes and reduce long-term healthcare expenditures. This measure reflects a commitment to comprehensive healthcare reform, recognizing that the inclusion of dental and vision services is vital to the health and wellbeing of the State's residents.

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

"§431:10A- Coverage for dental and vision treatment; notice. (a) Any other law to the contrary notwithstanding, each employer group health policy, contract, plan, or agreement issued or renewed in this State after December 31, 2025, that provides coverage to policyholders, shall provide, not as an employer option and not as a deductible, coverage for dental and vision preventative care, diagnosis, and treatment. The coverage provided shall in no way diminish or limit diagnostic benefits otherwise provided.

(b) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders within calendar year 2026 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2026."

SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to part VI of article 1 to be appropriately designated and to read as follows:

"§432:1- Coverage for dental and vision treatment; notice. (a) Any other law to the contrary notwithstanding, each individual and group hospital or medical service plan, policy, contract, or agreement issued or renewed in this State after December 31, 2025, that provides coverage, shall provide, not as an employer option and not as a deductible, coverage for dental and vision preventative care, diagnosis, and treatment.

(b) Every mutual benefit society shall provide notice to its members regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to members and shall be transmitted to members within calendar year 2026 when annual information is made available to members, or in any other mailing to members, but in no case later than December 31, 2026."

SECTION 4. Section 432D:23, Hawaii Revised Statutes, is amended to read as follows:

"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A‑116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, and [~~431:10A-134,~~] 431:10A- , and chapter 431M."

SECTION 5. The benefit to be provided by health maintenance organizations corresponding to the benefit provided under sections 431:10A- , Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 4 of this Act, shall take effect for all policies, contracts, plans, or agreements issued in the State after December 31, 2025.

SECTION 6. The coverage required under sections 2, 3, and 4 of this Act shall apply to all plans under medicaid managed care programs in the State.

SECTION 7. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 8. This Act shall take effect on July 1, 2025; provided that sections 2, 3, and 4 shall apply to all policies, contracts, plans, or agreements issued or renewed in the State after December 31, 2025; provided further that section 6 shall take effect upon approval of the Hawaii medicaid state plan by the Centers for Medicare and Medicaid Services.

INTRODUCED BY:	_____________________________

Report Title:

Health Insurance; Mandated Coverage

Description:

Requires all health insurers in the State, including Medicaid managed care programs, to cover dental and vision treatment.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

SB 1172: RELATING TO EMPLOYER HEALTH CARE REQUIREMENTS.

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