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Survey of Dental Benefit Providers Produces Mixed Results

Survey of Dental Benefit Providers Produces Mixed Results

Trends Include Pre-Paid Dental Care, Special Services

BY PATTI STRICKLAND

The San Diego Business Journal obtained information from 16 companies for this year’s List of Dental Benefit Providers, with a total of 1.11 million enrollees in San Diego County approximately 1 percent less than the roughly 1.12 million enrollees reported for those providers as of last year.

San Diego County accounts for 6 percent of the providers’ 19.1 million statewide enrollees, and 2 percent of the 47.9 million companywide enrollees.

Total San Diego County enrollees as of May 31, 2003 were used to rank this year’s List of Dental Benefit Providers. This figure includes dependents.

Of the 16 providers on The List, four are new to the Business Journal: PMI Dental Health Plan, No. 5; Fortis Benefits Insurance Co., No. 6; Western Dental Services, Inc., No. 8; and Liberty Dental Plan of California, No. 15.

PMI Dental Health Plan is a subsidiary of San Francisco-based Delta Dental Benefit Providers, No. 1 on this year’s List. With 407,343 enrollees, Delta’s enrollee figures are down 30 percent from last year’s 578,047. Delta did, however, report an increase in statewide and companywide enrollees, 700,000 more statewide, and 2.2 million more companywide since last year’s List.

Elizabeth Risberg, public relations specialist for Delta Dental, says this decrease is only because for this year’s List, Delta separated PMI enrollees from Delta’s total enrollees.

“PMI had, and still has, a separate Knox-Keene license so it is easier for us to keep Delta and PMI as two separate companies,” Risberg said. “It makes sense to retain each company under its already existing license.”

California requires managed care companies to obtain a limited license under the Knox-Keene Act so that the state can regulate and monitor the financial condition of those entities and ensure patient care and physician financial security.

Delta Dental reports nearly 270,000 more enrollees than Guardian Life Insurance Co., No. 2 on this year’s List. With 137,640 enrollees, Guardian Life Insurance Co. increased its enrollees 72 percent from the 79,824 reported for 2002.

Gregg Holdgrafer, regional sales director for Guardian says that this increase is because the provider offers voluntary dental on all of their plans.

“We have a wide range of plans for employers and brokers to choose from,” Holdgrafer said. “We also have written a tremendous amount of ASO (administrative services only) This is where companies self-fund their own dental plan and we just do the administration.”

CDN, No. 3 on The List, and a division of Downers, Ill.-based First Health Network reported 112,853 enrollees in 2003, down 3 percent from last year’s 116,375. Of CDN’s 148,618 statewide (and companywide) enrollees, San Diego County represents 76 percent.

– Pre-Paid Dental Plan Doubles Enrollment

Established in 2002, Newport Beach, Calif.-based Liberty Dental Plan of California reported the highest increase of all providers on the Business Journal’s List this year. Ranked at No. 15, Liberty Dental experienced a 123 percent increase in enrollees in 2003, up to 4,800 from 2002’s 2,150.

Dr. Amir Neshat, president and CEO of Liberty Dental, says that the market has been welcoming to newly developed pre-paid dental plans.

“The only type of dental plans that quality of care is monitored (if administered properly) and the consumers can rely on their plan administrator to watch their backs are pre-paid dental plans,” Neshat said. “PPO’s offer a wider selection of providers compared to pre-paid plans but when you compare them they are much more expensive, they come with a variety of limiting factors such as deductibles, annual limits, pre-existing exclusions, which are all waved in the pre-paid models.”

The Standard Insurance, No. 11 on last year’s List, did not return a survey this year.

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