August 18, 2017 10:19 PM ET

Healthcare Providers and Services

Company Overview of Delta Dental of California

Company Overview

Delta Dental of California, a dental carrier, provides dental benefit plans. The company offers managed fee-for-service plans for purchasers to select from various licensed dentists; prepaid plans for enrollees to select from a given network of dentists; mid-priced managed fee-for-service plans to select a preferred dentist; and prepaid plans to select a dentist in California. It also provides dental insurance plans through its subsidiary. The company offers its plans to individuals, families, seniors, retirees, and businesses, as well as for federal, state, and local government agencies. It allows customers to access various dentist locations in the United States, Canada, Mexico, Puerto Ric...

100 First Street

Suite 2100

San Francisco, CA 94105

United States

Founded in 1955

Phone:

415-972-8300

Fax:

415-972-8466

Key Executives for Delta Dental of California

President and Chief Executive Officer
Chief Financial Officer and Executive Vice President
Chief Operations Officer and Executive Vice President
Chief Legal Officer and Executive Vice President
Executive Vice President and Chief Sales & Marketing Officer
Compensation as of Fiscal Year 2017.

Delta Dental of California Key Developments

Delta Dental of California Names Group Vice President of Sales

Delta Dental of California and its affiliated companies have announced the promotion of MohammadReza Navid to group vice president of sales. Navid, who joined Delta Dental of California as vice president of sales in 2006, will oversee sales, sales administration and shared services for the group of companies in 15 states plus the District of Columbia. Under his leadership, the organization will continue to focus on meeting the needs of customers and strengthening its marketplace position.

California Dental Association Achieves Favorable Settlement with Delta Dental of California

The California Dental Association has reached a proposed settlement agreement with Delta Dental of California in its lawsuit against the insurer regarding CDA's claims that Delta breached its contractual commitments with thousands of dentists in the state. The CDA filed the legal action in August 2013 in response to Delta Dental's plans to reduce reimbursement rates for the Premier plan by 8% to 12%. The CDA claimed that Delta Dental's attempt to amend the participating dentist agreement — or PDA — was a breach of contract and that Delta Dental had not adequately disclosed its plan to reduce reimbursement rates. During the course of litigation, the CDA also discovered that Delta Dental had been imposing additional limitations on provider annual fee filings for participation in the Premier network that the PDAs did not allow. Delta Dental denied the CDA's allegations and claims, and maintained that the PDA expressly permitted the proposed amendments and that they were made in accordance with California's Knox-Keene Act governing health care service plans. The Knox-Keene Act is a law that regulates and licenses managed care plans. The CDA's proposed settlement agreement is on behalf of all California dentists who were contracted in the Delta Dental Premier network any time between Jan. 1, 2011, and Dec. 31, 2016. The settlement agreement has been submitted to the Superior Court of California in San Francisco, which will consider it in a public hearing later this month. Delta Dental must provide 120 days' written notice of significant PDA changes to all contracted providers, instead of the 45 days' notice currently required by California law. Delta Dental must provide each Premier provider affected by any attempt to reduce reimbursement fee maximum levels with an individualized analysis of the potential financial impact to his or her practice, based on that dentist's prior 12-month submissions to Delta Dental. Delta Dental must also provide 12 days' notice to the CDA of changes to PDAs so that CDA can have time to review the changes before they are implemented and be prepared to respond to member inquiries. Delta Dental must pay $34,750,000 to Premier providers who filed annual fee adjustments with Delta Dental that were below the maximum amounts allowed but that were nonetheless reduced by Delta Dental based on its own self-determined "inflation adjustment percentage" (referred to by Delta Dental as "INAP"). Not every Premier provider had fees reduced by the INAP, in which case those individuals will not receive any payment. Those dentists who did have their fees limited by this procedure will receive some proportionate retroactive reimbursement. None of this settlement amount goes toward attorney fees. In addition to the settlement amount, Delta Dental will pay CDA $1.5 million as reimbursement for a portion of the attorney's fees that it expended in pursuing the case. Delta Dental must also pay for the cost of implementing the settlement.

Delta Dental of California Promotes Tom Leibowitz to Group Vice President of Underwriting, Actuarial

Delta Dental of California and affiliates promoted Tom Leibowitz to group vice president of underwriting and actuarial. Leibowitz was previously chief actuary and vice president of actuarial at Delta Dental.

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