Delta Dental
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Delta Dental is the largest dental plan system in the United States. The Delta Dental Plans Association comprises 39 independent Delta Dental member companies operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 50 million people, enrolled in over 88,000 groups.[1] While many of the Delta Dental member companies and the Delta Dental Plans Association (DDPA) are non-profit organizations, a few of the member companies have for-profit segments.
Delta Dental member companies serve over one-quarter of the estimated 165 million Americans with dental insurance.[2]
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[edit] History
Delta Dental's roots go back to 1954 with the formation of dental service corporations in California, Oregon and Washington, which were created by dentists who recognized the need to increase access to oral health care. Led by Washington Dental Service (WDS), Delta Dental began by providing dental benefit programs for organized labor unions.
Delta Dental Plans Association (DDPA) was created in 1966 to bring together these local state service organizations and coordinate dental benefit programs for customers with employees in multiple states. A year later, the first multi-state program was sold by WDS to the International Association of Machinists. WDS ceded the administration for enrollees in other states to other Delta Dental member companies and contracted with the Blue Cross and Blue Shield Association for administration in those states without a Delta Dental affiliate organization.
Coverage was provided this way until the late 1980s when the Delta Dental of California (DDCA) won the bid for the Office of the Civilian Health and Medical Program of the Uniformed Services (OCHAMPUS) program. Delta Dental member companies agreed to share its provider data so the administration of this very large account could be centralized, with Delta Dental of California sharing the administrative income and risk. The OCHAMPUS program led to the creation of the National Provider File (NPF), which was made available for commercial accounts in 1990 via Delta USA – providing Delta Dental coverage to organizations with employees and subscribers located in multiple states.
[edit] Current structure
The Delta Dental system's mandate is to increase the future definition of dental benefits to improve access to dental care. It does this by encouraging the expansion of dental benefit programs administered through their 39 member companies. Delta Dental provides the means for these service corporations to cooperate in the provision of multi-state and national group dental coverage.
The headquarters of a company dictates which Delta Dental member company will provide insurance for that company. While there are only 39 member companies, every state is covered by a member company. For instance, one of the larger member companies, Delta Dental Insurance Company (DDIC), provides coverage for Alabama, Alaska, Florida, Georgia, Louisiana, Mississippi, Montana, Nevada, Texas, and Utah. DDIC is also affiliated with Delta Dental of California, giving them a total coverage area of 16 states and the District of Columbia. The size of a member company varies a great deal, with the largest in the thousands of employees, down to the smallest with tens of employees.
While the member companies are individual and very independent companies, there is an association they all belong to called Delta Dental Plans Association (DDPA). This association is incorporated as a trade association. DDPA does not function as a corporate headquarters. It is a coordinating body that provides a number of services that multiple plans need as well as directing inquiries to the appropriate Delta Dental member company. DDPA is a very small company of about 30 people out of Oak Brook, IL. It is not to be confused with Delta Dental of Illinois, which has 120+ people and is based in Lisle, IL. DDPA manages the Delta Dental brand, helps organize meetings, ties all the member companies together and allows them to price claims in other states. The National Provider File (NPF) allows these localized companies to write national business. This allows a subscriber to go to any provider signed up with the Delta Dental system throughout the country.
[edit] Plan Assignment
If individuals have dental insurance through their employer, the Delta Dental member company in the state of their headquarters will handle coverage. Private insurance options are held by Delta Dental of California. Military contracts are handled by Tricare through separate active duty and retiree programs. There is a dental insurance option through AARP that has their own hot line as well. This structure grew out of the history of Delta Dental.
[edit] Cavity Reduction Support
Delta Dental companies are actively engaged in many studies, grants and partnerships with dental schools and community health organizations to increase access to professional dental care as well as to research evidence-based dentistry and the efficacy of new benefit designs. A recent Daily Mail article from the UK cited an $11M USD contribution to support the creation of an innovative lollipop that reduces the presence of cavity-causing bacteria in the mouth. Although it's true that several Delta Dental Plans are involved in related research concerning anti-microbial lollipops (Delta Dental of CA, Delta Dental of WI and Washington Dental Service), the amount attributed in this Daily Mail article as a contribution from Delta Dental is not verified. [3] The sugar free lollipop is currently available online and uses licorice extract to reduce the incidence of Streptococcus mutans, a virulent cavity causing bacteria.
