# Conn. Gen. Stat. § 38a-472h: Sec. 38a-472h. Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required > Connecticut · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472h ## Section - **Citation:** Conn. Gen. Stat. § 38a-472h - **Heading:** Sec. 38a-472h. Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required - **Jurisdiction:** Connecticut - **Kind:** Statutes - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Connecticut Code / Title 38a / Chapter 700c / Section 38a-472h ## Text (1) An individual or a group dental plan in this state shall include in any contract with a dentist licensed pursuant to chapter 379 that is entered into, renewed or amended on or after January 1, 2012, any provision that requires such dentist to accept as payment an amount set by such insurer, center, society, corporation or entity for services or procedures provided to an insured or enrollee that are not covered benefits under such insured's or enrollee's plan; or (2) An individual or a group vision plan in this state shall include in any contract with an optometrist licensed pursuant to chapter 380 or an ophthalmologist licensed pursuant to chapter 370 that is entered into, renewed or amended on or after January 1, 2020, any provision that requires such optometrist or ophthalmologist to accept as payment an amount set by such insurer, center, society, corporation or entity for services, procedures or products provided to an insured or enrollee that are not covered benefits under such insured's or enrollee's plan. (b) No dentist shall charge more for services or procedures that are not covered benefits than such dentist's usual and customary rate for such services or procedures, and no optometrist or ophthalmologist shall charge more for services, procedures or products that are not covered benefits than such optometrist's or ophthalmologist's usual and customary rate for such services, procedures or products. (c) (1) Each evidence of coverage for an individual or a group dental plan shall include the following statement: “IMPORTANT: If you opt to receive dental services or procedures that are not covered benefits under this plan, a participating dental provider may charge you his or her usual and customary rate for such services or procedures. Prior to providing you with dental services or procedures that are not covered benefits, the dental provider should provide you with a treatment plan that includes each anticipated service or procedure to be provided and the estimated cost of each such service or procedure. To fully understand your coverage, you may wish to review your evidence of coverage document.” (2) Each evidence of coverage for an individual or a group vision plan shall include the following statement: “IMPORTANT: If you opt to receive optometric or ophthalmologic services, procedures or products that are not covered benefits under this plan, a participating optometrist or ophthalmologist may charge you his or her usual and customary rate for such services, procedures or products. Prior to providing you with optometric or ophthalmologic services, procedures or products that are not covered benefits, the optometrist or ophthalmologist should provide you with a treatment plan that includes each anticipated service, procedure or product to be provided and the estimated cost of each such service, procedure or product. To fully understand your coverage, you may wish to review your evidence of coverage document.” (d) Each dentist, optometrist and ophthalmologist shall post, in a conspicuous place, a notice stating that services, procedures or products, as applicable, that are not covered benefits under an insurance policy or plan might not be offered at a discounted rate. each such service, procedure or product. To fully understand your coverage, you may wish to review your evidence of coverage document.” (d) Each dentist, optometrist and ophthalmologist shall post, in a conspicuous place, a notice stating that services, procedures or products, as applicable, that are not covered benefits under an insurance policy or plan might not be offered at a discounted rate. (e) The provisions of this section shall not apply to: (1) A self-insured plan that covers (A) dental services or procedures, or (B) optometric or ophthalmologic services, procedures or products; (2) A contract that is incorporated in or derived from a collective bargaining agreement or in which some or all of the material terms are subject to a collective bargaining process; (3) A contract that is derived from a multiemployer plan, as defined in Section 3 of the Employee Retirement Income Security Act of 1974, as amended from time to time; or (4) A network of ophthalmologists or optometrists, or both, when servicing a plan or contract described in subdivision (1), (2) or (3) of this subsection. See Sec. 20-138b re health care center or preferred provider network offering ophthalmologic care and optometric care. See Sec. 20-138d re coverage for services of optometrists. ## Nearby sections - [Conn. Gen. Stat. § 38a-470 Sec. 38a-470. (Formerly Sec. 38-174n). Lien on workers' compensation awards for insurers. Notice of lien.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-470.md) - [Conn. Gen. Stat. § 38a-471 Sec. 38a-471. (Formerly Sec. 38-174o). Third party prescription programs. Notice of cancellation. Applicability of section.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-471.md) - [Conn. Gen. Stat. § 38a-472 Sec. 38a-472. (Formerly Sec. 38-174a). Assignment of insurance proceeds to doctor, hospital or state agency. Lien for state care. Notice of lien.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472.md) - [Conn. Gen. Stat. § 38a-472c Sec. 38a-472c. Dental policies. Estimate of reimbursement. Material adjustments to fee schedules for in-network providers. Notice.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472c.md) - [Conn. Gen. Stat. § 38a-472d Sec. 38a-472d. Public education outreach program re health insurance availability and eligibility requirements.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472d.md) - [Conn. Gen. Stat. § 38a-472f Sec. 38a-472f. Network adequacy. Health carrier duties and responsibilities. Access plan filing.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472f.md) - [Conn. Gen. Stat. § 38a-472g Sec. 38a-472g. Restrictions applicable to prior authorization or precertification.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472g.md) - [Conn. Gen. Stat. § 38a-472h Sec. 38a-472h. Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472h.md) - [Conn. Gen. Stat. § 38a-472i Sec. 38a-472i. Payment amount of professional services component of covered colonoscopy or endoscopic services.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472i.md) - [Conn. Gen. Stat. § 38a-472j Sec. 38a-472j. Restrictions applicable to cost-sharing for covered benefits. Regulations.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472j.md) - [Conn. Gen. Stat. § 38a-472l Sec. 38a-472l. Participating dental provider contracts. Third-party access. Restrictions. Exceptions.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472l.md) - [Conn. Gen. Stat. § 38a-473 Sec. 38a-473. Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-473.md) - [Conn. Gen. Stat. § 38a-474 Sec. 38a-474. Medicare supplement policy rate increases: Procedure. Age, gender, previous claim or medical history rating prohibited.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-474.md) - [Conn. Gen. Stat. § 38a-475 Sec. 38a-475. Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-475.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472h. Check the current official text before relying on it. Not legal advice.