Dental health

Our consultants have extensive experience helping clients launch new products and enter new markets. We offer support related to dental insurance product design, ranging from defining covered services to designing cost- sharing structures and utilization controls to meet financial and strategic goals. We have assisted insurance carriers with the design of new products and the adaptation of existing product lines to new markets. We have decades of pricing and product development experience, supported by healthcare data, independent research, and proprietary tools.

Our consultants have broad reserving experience specifically for dental products. We regularly assist clients with their reserving needs, including incurred but not reported reserve calculations, premium deficiency reserves and other reserve calculations, formal statements of actuarial opinion, and other appointed actuary support. Milliman also offers the Claim Reserve Estimation Workbook (CREW), a flexible Microsoft Excel-based model to estimate incurred but not reported (IBNR) liabilities. CREW’s primary asset is its ability to accommodate unusual claim payment patterns, as well as changing enrollments, benefits, unit costs, and other key factors like changes in capitation and provider contracts.

Our experts assist employer clients with managing their dental benefit, including private employers, public employers, and multi-employer pools. We offer comprehensive dental request for proposal (RFP) support services, including drafting RFP questionnaires, administering the RFP, evaluating bidder responses, conducting repricing analyses, and providing insights to assist in final vendor selection. We regularly assist plan sponsors with self-insured benefits to balance offering valuable benefits to employees while meeting financial goals, via plan design support, experience monitoring and benchmarking, annual budgeting and premium equivalent development, and periodic capital needs and reserve analyses.

Our consultants routinely assist clients with dental provider network development and management, providing insight through analytic and strategic support. We have completed analyses to assess the breadth and depth of networks and produce benchmarks for discounts and provider reimbursement levels. We have assisted new insurance carriers with building a provider network and helped established carriers strategically expand existing provider networks. We have experience with developing provider fee strategies to expand access to care while controlling costs and meeting financial goals.

Milliman offers a comprehensive annual PPO network study for dental insurers. The analysis uses claims data provided by study participants and develops competitive market insights into PPO network discounts and network size for participants in the study. The results from the analysis are used to provide strategic insight into both a dental insurer’s own provider networks and the provider network landscape. Through this analysis, insurers are better able to understand their competitive network position and to address areas in which they want to compete or perform better.