An Overview

The Delaware Valley Health Care Coalition (DVHCC) began it's relationship with Delta Dental in March of 1998. Delta offers a hybrid in dental insurance: the processing economies of large fee-for-service coverage with the dental economies of managed care.

Delta Dental is the nation’s largest, most experienced dental benefits carrier. A nationwide system of dental health service plans, Delta Dental offers employers, large and small custom programs and reporting systems that provide employees with quality, cost-effective dental benefit programs and services.

Statistics on Delta Dental’s Health Care Leadership

• Delta Dental member Plans serve approximately one-quarter of the estimated 120 million Americans with dental insurance, providing dental coverage to over 42 million people in more than 75, 000 groups across the nation.
• Delta Dental’s panel of dentists for its fee-for-service product is the country’s most extensive. Delta contracts with 107,505 dentists - or almost three out of every four U.S. dentists - in 134,563 locations. These practitioners are also part of DeltaUSA’s (Delta Dental’s National Accounts Program) fee-for-service product network - Delta Premier USA.
• Delta Dental Plans posted approximately $8.8 billion in premium revenue during fiscal year 2001, the system’s 21st consecutive year of financially gains.
• In 2000, Delta Plans processed nearly 56 million dental claims or nearly 1,077,000 every week, with an accuracy rate of 99 percent.
• Since 1954, Delta Dental has worked to improve oral health in the U.S. by emphasizing preventive care, and making dental coverage affordable to a wide variety of employers and groups.
• Delta Dental’s unique cost control measures and contractual agreements with dentists help to ensure quality at moderate fees, saving groups over $2.6 billion in 2001.

Delta Dental Products

Delta Dental Plans offer a variety of local programs what range from traditional fee-for service and preferred-provider programs (DPOs) to dental health maintenance organizations (DHMOs) and Point-of-Service (POS), as well as customized programs as needed. Delta Dental also offers dental programs to national account groups. Through DeltaUSA, DDPA’s national accounts program, Delta Dental Member Plans provide quality, uniform dental benefits programs to groups with a multi-state labor force. These products include:

• Managed fee-for-service products: DeltaPremier USA
• Dental preferred-provider organizations (PPOs): DeltaPreferred Option USA
• Dental health maintenance organizations (DHMOs): DeltaCare USA
• National voluntary group customers and Tricare (dental benefits program for uniformed military retirees and their families): DeltaSeclect USA

Delta USA National Network Statistics:

• As of December 2001, DeltaPreferred Option USA (Preferred Provider Option) has over 43,638 contracted dentists practicing in 58,495 locations.
• As of June 2002, DeltaCare USA has 11,122 points of access in 7,971 offices.
• As of June 2002, DeltaPremier USA has 107,505 contracted practicing dentists in 134,563 office locations.

Organization

Delta Dental is a network of 37 independent dental plans that conduct business in all 50 states, the District of Columbia and Puerto Rico. These Plans are all members of the delta Dental Plans Association (DDPA); whose mission is to help improve the overall oral health of the nation by making dental benefits programs. This mission is accomplished through the Plans’ partnerships with their dentists and customers, resulting in real solutions to oral health care, with a focus on prevention.

The Association exists to service its Plans and enhance their ability to provide dental benefits programs to customers and subscribers. Among its many functions, DDPA fosters communication and education between Plans, establishes a corporate identity for the system, represents Delta Dental on federal legislative issues, and collaborates with other organizations in the health care and benefits industry. In addition, the Association is leading the charge in outcomes research and the analysis of the application of emerging dental science and its effects on the improvements of people’s oral health.

Cost Management

Delta's vigorous cost management system currently results in an overall savings to purchasers of 15% annually. These savings are achieved through:

• Participating dentist network discounting
• Usual, Customary and Reasonable payment methodology (Mega 2 discounting)
• Efficient claims processing
• Coordination of benefits
• Dentist consultant review
• Added cont-controlling contract limits.

Quality Assurance

A comprehensive quality assurance system with accuracy checks at each processing step, internal audits, mail surveys of one percent of recipients, and seven percent telephone follow-up on claims inquiries to guarantee satisfaction.

Delta Participating Dentists

• Agree to Accept Delta's calculation of UCR as payment in full
• Provide treatment in accordance with the best dental practice in the community at the time, with regard to the quality of service and appropriateness of treatment
• Submit claims on behalf of Delta subscriber

Delta Dental Labor Union Involvement

• About one third of Delta's business is purchased by Unions or employers with Unions
• All of the construction at Delta is done 100% by the Building Trades Union
• The office in Mechanicsburg is organized by UNITE.
• Delta's offices across the country are organized by the IUE, UAW and IBT.
• Recognized by the AFL-CIO as "Union Label Product"
• All printing is done by Union Printers.