Washington Dental Loss Ratios

$179 / year

This dataset serves as a dental insurance summary database for Performance Year (PY) 2015-2016. This dataset is cumulative at the company level as reported to the National Association of Insurance Commissioners (NAIC).

Complexity

Insurance industry dental loss ratios (DLRs) represent expenditures for patient services as a percentage of total premium dollars. A well-managed dental insurance plan allows maximal dollars toward patient care and the least amount toward administrative overhead.

Under the Affordable Care Act (ACA), medical insurance plans are required to minimally operate at an 85% medical loss ratio (MLR) for larger carriers and 80% MLR for smaller health insurance companies. Dental insurance is quite different than medical insurance in fundamental ways. Potential dental insurance company losses for payout of patient benefits are far more actuarially predictable. Most dental insurance companies impose yearly maximal payouts limited to only $1,000 to $1,500. Medical insurance may be on the hook for unlimited sums, in the event of catastrophic illness. In fact, few if any dental plans cover catastrophic events or major oral rehabilitation.

Dental insurance plans focus coverage on low-cost preventive care. The least percentage coverage is for more involved restorative treatments, like crowns and fixed bridge work. Further, many dental plans disallow payments for implant services altogether.

Note: While the data is for a company’s total (national) business, only those companies that report having health premiums in the state of Washington are included in this listing.

Date Created

2017-07-17

Last Modified

2018-02-03

Version

2018-02-03

Update Frequency

Annual

Temporal Coverage

2015-2016

Spatial Coverage

Washington

Source

John Snow Labs; National Association of Insurance Commissioners;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Dental Loss Ratios, Dental Expenditures, Dental Premiums, Dental Insurance Plans, Dental Coverage, Insurance Plans, Dental Association, Health Premiums, Preventive, Dental Insurance Database

Other Titles

Dental Plans in Washington Market, Dental Plans in Market

NameDescriptionTypeConstraints
Company_NameName of enrolled companystring-
CocodeFive-digit number that uniquely identifies an insurance companyintegerlevel : Nominal
State_AbbreviationState abbreviation of the company’s legal residencestring-
Business_TypeLine of business under which an insurance company is licensed by its State of Domicile. L=Life P=Property/Casualty X=Healthstring-
YearPlan Year represented by the rowdate-
Dental_PremiumsPremiums earned for the year from Dental policies that provide only dental treatment benefits.number-
Dental_PaymentsDirect costs incurred providing dental treatment benefits excluding administrative costs.number-
Dental_MembersThe total number of lives insured, including dependents, under individual policies and group certificates as of December 31 of the reporting year.integerlevel : Ratio
Dental_Member_MonthsThe sum of total number of lives insured on a pre-specified day of each month of the reported year.integerlevel : Ratio
Dental_Loss_RatioRatio of dental loss per yearnumberlevel : Ratio
Average_Amount_of_PremiumsAverage Amount of Premiums per Member per Monthnumber-
Previous_Year_Average_Amount_of_PremiumsPrevious Year Average Amount of Premiums per Member per Monthnumber-
Percentage_Change_in_Average_PremiumsPercentage Change in Average Premiums per Member per Month from Previous Yearnumberlevel : Ratio
Company_NameCocodeState_AbbreviationBusiness_TypeYearDental_PremiumsDental_PaymentsDental_MembersDental_Member_MonthsDental_Loss_RatioAverage_Amount_of_PremiumsPrevious_Year_Average_Amount_of_PremiumsPercentage_Change_in_Average_Premiums
THE PAUL REVERE LIFE INSURANCE COMPANY67598MALife2015733184.06
HORACE MANN LIFE INSURANCE COMPANY64513ILLife2015801651678040.69.97
ASURIS NORTHWEST HEALTH47350WAHealth201568371347687715691891269.736.15
FAMILY LIFE INSURANCE COMPANY63053TXLife20155829449897189171485.634.01
AXIS Insurance Company37273ILProperty201531867515786416551961449.516.25
Premera Blue Cross47570WAHealth2015426958683223790081681101169175.542.2
Regence BlueShield53902WAHealth201524958753197860675318364028879.338.98
GERBER LIFE INSURANCE COMPANY70939NYLife201569389944266914351722063.840.3
Group Health Options, Inc.47055WAHealth2015294349826210724987597218949.29
UNIFIED LIFE INSURANCE COMPANY11121TXLife2015161681122280154192075.684.21