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

2020-01-16

Version

2020-01-16

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
4 Ever Life Insurance Company80985ILL20151240092124009255697367559241000
ACE AMERICAN INSURANCE COMPANY22667PAP2015668687783041011640725738665004617
AETNA LIFE INSURANCE COMPANY60054CTL2015162195679212433797233675656444477527736
American Family Life Assurance Company of Columbus (AFLAC)60380NEL20151700630107089237953665860601044228
American Fidelity Assurance Company60410OKL20151312593248939960972522
American General Life Insurance Company60488TXL2015106182855338377281243374885031
American Heritage Life Insurance Company60534FLL2015124383848550518670288258394
American National Life Insurance Company of Texas71773TXL2015122254127064993440565087885824
AMERICAN PUBLIC LIFE INS CO60801OKL20152705445147986510978396275568
AMERICAN REPUBLIC INSURANCE COMPANY60836IAL2015447887431222956785796817056