Dental covered, with caveats · Last verified 2026-08-29
Mont. Code Ann. §33-18-232; §33-18-231; §33-18-233
Under Mont. Code Ann. §33-18-232; §33-18-231; §33-18-233, the Montana payment deadline is 30 days for clean/complete claims. A non-compliant insurer liable on the claim owes the claim plus 10% annual interest from the date the claim was due (day 30, or day 60 after an information request) — but only when the computed interest exceeds $5 (§33-18-232(2)). Dental applicability: Covered for dental insurers and dental service corporations: the definition of insurer sweeps in any entity promising to pay medical benefits, and health service corporations are doubly covered by §33-30-102. Self-funded (ERISA) plans are outside this statute — federal ERISA deadlines apply to them instead.
Insurers must pay or deny within 30 days after receipt of proof of loss — extended to 60 days from the original receipt when the insurer makes a reasonable request for additional information. Montana draws no electronic-vs-paper distinction.
A non-compliant insurer liable on the claim owes the claim plus 10% annual interest from the date the claim was due (day 30, or day 60 after an information request) — but only when the computed interest exceeds $5 (§33-18-232(2)). The $25,000 figure that circulates is not in this section: it is the Commissioner's general administrative fine (§33-1-317), available after a hearing for insurers that fail to pay timely as a general course of business (§33-18-233).
Covered for dental insurers and dental service corporations: the definition of insurer sweeps in any entity promising to pay medical benefits, and health service corporations are doubly covered by §33-30-102. One unresolved corner: Chapter 31 HMOs — the HMO code's list of applicable insurance laws does not include the prompt-pay part, so do not assume the interest rule reaches a dental HMO without checking with the Commissioner of Securities and Insurance.
Self-funded (ERISA) plans: Self-funded employer (ERISA) dental plans are outside every state prompt-pay statute — federal law preempts state insurance regulation of self-funded plans. Those claims run on the federal ERISA claims-procedure deadlines instead: a post-service benefit determination within 30 days (one 15-day extension), at least 180 days to appeal, and an appeal decision within 60 days (or two 30-day levels), under 29 CFR 2560.503-1.
Uses the verified Montana rule (Mont. Code Ann. §33-18-232; §33-18-231; §33-18-233). Estimate only — the statute's own accrual triggers control.
Estimated interest
$10.48
10% per year (simple)
Payable only if the interest due on the claim exceeds $5; paid to whoever receives the claim payment.
Formula: claim × 10% × days late ÷ 365, using simple (not compounded) interest as the statute states it. The rate and deadline come from Mont. Code Ann. §33-18-232; §33-18-231; §33-18-233, verified against the statute text linked in the sources on this page (last verified 2026-08-29). Accrual start dates, clean-claim status, safe harbors, and plan funding all affect the real figure — treat this as an estimate for the payer conversation, not a demandable amount.
