Cost Management Report Delta Dental Network Coverage Network Utilization Discount Delta Dental PPO Network 28.3% 29.4% Delta Dental Premier Network 67.0% 12.0% Total 95.3% Savings Categories $ % of Net Submitted Dollars % of Paid Dollars Total Submitted Claims $26,518,502 RFI/Duplicate/Eligibility $1,264,362 9.0% Net Submitted Claims $25,254,140 Claims Management Savings Non-Covered Services $746,991 3.0% 5.3% Professional Review $207,244 0.8% 1.5% Non-Billable Services* $96,918 0.4% 0.7% Optional Services $22,734 0.1% 0.2% Coordination of Benefits $144,270 0.6% 1.0% Subtotal $2,482,519 4.8% 17.7% Delta Dental Difference Savings Delta Dental PPO Network $2,095,872 8.3% 15.0% Delta Dental Premier Network $2,003,442 7.9% 14.3% Out-of-Network $47,109 0.2% 0.3% Subtotal $4,146,424 16.4% 29.6% Program Design/Member Responsibility Savings Deductible Applied $1,330,264 5.3% 9.5% Patient Coinsurance $3,136,907 12.4% 22.4% Over Maximums $1,423,059 5.6% 10.2% Subtotal $5,890,231 23.3% 42.1% Total Savings $12,519,173 Total Paid Claims $13,999,289 *When treatment is received from a Delta Dental participating dentist these charges are not billed to the patient. These do not represent network discount percentages. 1 01/08/2017
Delta Dental Network Coverage Network Utilization Number of Services Net Submitted Claims Discount Paid Claims Delta Dental PPO Network 54,882 $7,129,557 29.4% $3,223,092 Delta Dental Premier Network 129,823 $16,671,298 12.0% $9,939,049 Out-of-Network 9,084 $1,453,285 3.2% $837,148 Total 193,789 $25,254,140 16.4% $13,999,289 2 01/08/2017
Paid Claims by Member Type & Service Member Type Paid Claims % of Paid Claims Employee $7,581,664 54.2% Spouse $3,068,613 21.9% Children $3,349,013 23.9% Total $13,999,289 100.0% Dental Service Paid Claims % of Paid Claims Preventive Services $8,407,431 60.1% Basic Services $3,252,799 23.2% Major Services $2,339,060 16.7% Orthodontic Services $0 0.0% Total $13,999,289 100.0% 3 01/08/2017
Comparison to Delta Dental Book of Business (BOB) % of Services % of Benefit Dental Service Group Delta Dental BOB Group Delta Dental BOB Preventive Services 83.2% 77.9% 60.1% 51.8% Basic Services 13.9% 16.9% 23.2% 28.6% Major Services 2.9% 2.5% 16.7% 14.3% Orthodontic Services 0.0% 2.7% 0.0% 5.3% Network Utilization By Net Submitted Claims Group Delta Dental BOB Difference Delta Dental PPO Network 28.2% 53.9% -25.6% Delta Dental Premier Network 66.0% 39.5% 26.5% Out-of-Network 5.8% 6.6% -0.9% Savings Categories % of Total Submitted Dollars Delta Dental % of Total Submitted Dollars Difference Total Submitted Claims $26,518,502 $1,024,125,93 Claims Management Savings Request for Information 2.5% 5.4% -2.8% Duplicate Claims 2.2% 3.2% -1.0% Eligibility Verification 0.0% 0.0% 0.0% Non-Covered Services 2.8% 5.0% -2.2% Professional Review 0.8% 0.5% 0.3% Non-Billable Services 0.4% 0.4% -0.1% Optional Services 0.1% 0.8% -0.7% Coordination of Benefits 0.5% 1.0% -0.5% Subtotal 9.4% 16.2% -6.9% Delta Dental Difference Savings Delta Dental PPO Network 7.9% 15.2% -7.3% Delta Dental Premier Network 7.6% 5.3% 2.3% Out-of-Network 0.2% 1.0% -0.8% Subtotal 15.6% 21.5% -5.8% Program Design/Member Responsibility Savings Deductible Applied 5.0% 2.1% 2.9% Patient Coinsurance 11.8% 12.7% -0.9% Over Maximums 5.4% 5.0% 0.4% Subtotal 22.2% 21.6% 2.4% Total Savings 47.2% 54.7% -7.5% Total Paid Claims 52.8% 42.5% 10.3% 4 01/08/2017
Comparison by Member Type Total Paid Claims Type of Dental Service Employee Spouse Children Total Dental Prophylaxis $2,010,011 $769,544 $857,949 $3,637,504 Fluoride Treatments $0 $0 $321,480 $321,480 General Services $80,038 $31,233 $92,041 $203,311 Oral Evaluations $1,199,279 $467,629 $678,668 $2,345,575 Other Diagnostic $0 $0 $0 $0 Other Preventive $0 $0 $2,733 $2,733 Radiographs $960,733 $377,328 $436,684 $1,774,745 Sealants $0 $0 $111,866 $111,866 Space Maintainers $0 $0 $10,216 $10,216 Preventive Services $4,250,062 $1,645,733 $2,511,636 $8,407,431 % of Total 50.6% 19.6% 29.9% Amalgam & Composite Fillings $701,457 $293,594 $362,215 $1,357,265 Endodontics $456,093 $206,009 $52,731 $714,833 Extractions - Simple $76,166 $33,873 $41,373 $151,412 Extractions - Surgical $157,056 $60,164 $277,954 $495,174 Other Basic Services $125,406 $55,197 $26,828 $207,431 Periodontics - Non-Surgical $156,587 $67,308 $8,672 $232,567 Periodontics - Surgical $64,775 $23,714 $5,628 $94,116 Basic Services $1,737,539 $739,859 $775,400 $3,252,799 % of Total 53.4% 22.7% 23.8% Crowns $973,723 $413,075 $34,125 $1,420,923 Dentures - Complete $30,909 $18,709 $0 $49,618 Dentures - Partial $45,587 $18,640 $0 $64,227 Fixed Bridges $143,934 $62,676 $2,893 $209,504 Implants $313,145 $134,945 $14,524 $462,614 Inlays/Onlays $11,430 $3,015 $0 $14,445 Oral Surgery $46,650 $21,058 $10,282 $77,990 Other Prosthodontics $21,030 $6,916 $152 $28,098 Veneers $7,657 $3,986 $0 $11,643 Major Services $1,594,063 $683,020 $61,977 $2,339,060 % of Total 68.1% 29.2% 2.6% Orthodontics $0 $0 $0 $0 Orthodontic Services $0 $0 $0 $0 % of Total 0.0% 0.0% 0.0% Grand Total $7,581,664 $3,068,613 $3,349,013 $13,999,289 % of Grand Total 54.2% 21.9% 23.9% 100.0% 5 01/08/2017
Member Type - All Type of Dental Service Number of Services % of Total Paid Claims % of Total Dental Prophylaxis 53,398 27.6% $3,637,504 26.0% Fluoride Treatments 8,832 4.6% $321,480 2.3% General Services 2,344 1.2% $203,311 1.5% Oral Evaluations 55,036 28.4% $2,345,575 16.8% Other Diagnostic 3 0.0% $0 0.0% Other Preventive 164 0.1% $2,733 0.0% Radiographs 39,020 20.1% $1,774,745 12.7% Sealants 2,481 1.3% $111,866 0.8% Space Maintainers 35 0.0% $10,216 0.1% Preventive Services 161,313 83.2% $8,407,431 60.1% Amalgam & Composite Fillings 15,642 8.1% $1,357,265 9.7% Endodontics 1,335 0.7% $714,833 5.1% Extractions - Simple 2,376 1.2% $151,412 1.1% Extractions - Surgical 2,647 1.4% $495,174 3.5% Other Basic Services 2,770 1.4% $207,431 1.5% Periodontics - Non-Surgical 1,970 1.0% $232,567 1.7% Periodontics - Surgical 172 0.1% $94,116 0.7% Basic Services 26,912 13.9% $3,252,799 23.2% Crowns 3,420 1.8% $1,420,923 10.1% Dentures - Complete 117 0.1% $49,618 0.4% Dentures - Partial 145 0.1% $64,227 0.5% Fixed Bridges 595 0.3% $209,504 1.5% Implants 658 0.3% $462,614 3.3% Inlays/Onlays 35 0.0% $14,445 0.1% Oral Surgery 291 0.2% $77,990 0.6% Other Prosthodontics 268 0.1% $28,098 0.2% Veneers 31 0.0% $11,643 0.1% Major Services 5,560 2.9% $2,339,060 16.7% Orthodontics 4 0.0% $0 0.0% Orthodontic Services 4 0.0% $0 0.0% Grand Total 193,789 $13,999,289 6 01/08/2017
Member Type - Employee Type of Dental Service Number of Services % of Total Paid Claims % of Total Dental Prophylaxis 28,602 29.2% $2,010,011 26.5% Fluoride Treatments 7 0.0% $0 0.0% General Services 1,058 1.1% $80,038 1.1% Oral Evaluations 28,879 29.5% $1,199,279 15.8% Other Diagnostic 1 0.0% $0 0.0% Other Preventive 33 0.0% $0 0.0% Radiographs 21,061 21.5% $960,733 12.7% Sealants 1 0.0% $0 0.0% Space Maintainers 0 0.0% $0 0.0% Preventive Services 79,642 81.4% $4,250,062 56.1% 4,250,062 Amalgam & Composite Fillings 8,195 8.4% $701,457 9.3% Endodontics 805 0.8% $456,093 6.0% Extractions - Simple 1,200 1.2% $76,166 1.0% Extractions - Surgical 1,019 1.0% $157,056 2.1% Other Basic Services 1,743 1.8% $125,406 1.7% Periodontics - Non-Surgical 1,325 1.4% $156,587 2.1% Periodontics - Surgical 114 0.1% $64,775 0.9% Basic Services 14,401 14.7% $1,737,539 22.9% 1,737,539 Crowns 2,330 2.4% $973,723 12.8% Dentures - Complete 74 0.1% $30,909 0.4% Dentures - Partial 105 0.1% $45,587 0.6% Fixed Bridges 408 0.4% $143,934 1.9% Implants 441 0.5% $313,145 4.1% Inlays/Onlays 28 0.0% $11,430 0.2% Oral Surgery 180 0.2% $46,650 0.6% Other Prosthodontics 193 0.2% $21,030 0.3% Veneers 20 0.0% $7,657 0.1% Major Services 3,779 3.9% $1,594,063 21.0% 1,594,063 Orthodontics 2 0.0% $0 0.0% Orthodontic Services 2 0.0% $0 0.0% 0 Grand Total 97,824 $7,581,664 7 01/08/2017
Member Type - Spouse Type of Dental Service Number of Services % of Total Paid Claims % of Total Dental Prophylaxis 11,187 28.5% $769,544 25.1% Fluoride Treatments 4 0.0% $0 0.0% General Services 403 1.0% $31,233 1.0% Oral Evaluations 11,440 29.1% $467,629 15.2% Other Diagnostic 2 0.0% $0 0.0% Other Preventive 10 0.0% $0 0.0% Radiographs 8,508 21.6% $377,328 12.3% Sealants 0 0.0% $0 0.0% Space Maintainers 0 0.0% $0 0.0% Preventive Services 31,554 80.3% $1,645,733 53.6% 4,250,062 Amalgam & Composite Fillings 3,500 8.9% $293,594 9.6% Endodontics 359 0.9% $206,009 6.7% Extractions - Simple 527 1.3% $33,873 1.1% Extractions - Surgical 403 1.0% $60,164 2.0% Other Basic Services 736 1.9% $55,197 1.8% Periodontics - Non-Surgical 570 1.4% $67,308 2.2% Periodontics - Surgical 47 0.1% $23,714 0.8% Basic Services 6,142 15.6% $739,859 24.1% 1,737,539 Crowns 1,003 2.6% $413,075 13.5% Dentures - Complete 43 0.1% $18,709 0.6% Dentures - Partial 40 0.1% $18,640 0.6% Fixed Bridges 178 0.5% $62,676 2.0% Implants 196 0.5% $134,945 4.4% Inlays/Onlays 7 0.0% $3,015 0.1% Oral Surgery 67 0.2% $21,058 0.7% Other Prosthodontics 73 0.2% $6,916 0.2% Veneers 11 0.0% $3,986 0.1% Major Services 1,618 4.1% $683,020 22.3% 1,594,063 Orthodontics 0 0.0% $0 0.0% Orthodontic Services 0 0.0% $0 0.0% 0 Grand Total 39,314 $3,068,613 8 01/08/2017
Member Type - Children Type of Dental Service Number of Services % of Total Paid Claims % of Total Dental Prophylaxis 13,609 24.0% $857,949 25.6% Fluoride Treatments 8,821 15.6% $321,480 9.6% General Services 883 1.6% $92,041 2.7% Oral Evaluations 14,717 26.0% $678,668 20.3% Other Diagnostic 0 0.0% $0 0.0% Other Preventive 121 0.2% $2,733 0.1% Radiographs 9,451 16.7% $436,684 13.0% Sealants 2,480 4.4% $111,866 3.3% Space Maintainers 35 0.1% $10,216 0.3% Preventive Services 50,117 88.5% $2,511,636 75.0% 4,250,062 Amalgam & Composite Fillings 3,947 7.0% $362,215 10.8% Endodontics 171 0.3% $52,731 1.6% Extractions - Simple 649 1.1% $41,373 1.2% Extractions - Surgical 1,225 2.2% $277,954 8.3% Other Basic Services 291 0.5% $26,828 0.8% Periodontics - Non-Surgical 75 0.1% $8,672 0.3% Periodontics - Surgical 11 0.0% $5,628 0.2% Basic Services 6,369 11.2% $775,400 23.2% 1,737,539 Crowns 87 0.2% $34,125 1.0% Dentures - Complete 0 0.0% $0 0.0% Dentures - Partial 0 0.0% $0 0.0% Fixed Bridges 9 0.0% $2,893 0.1% Implants 21 0.0% $14,524 0.4% Inlays/Onlays 0 0.0% $0 0.0% Oral Surgery 44 0.1% $10,282 0.3% Other Prosthodontics 2 0.0% $152 0.0% Veneers 0 0.0% $0 0.0% Major Services 163 0.3% $61,977 1.9% 1,594,063 Orthodontics 2 0.0% $0 0.0% Orthodontic Services 2 0.0% $0 0.0% 0 Grand Total 56,651 $3,349,013 9 01/08/2017
Number of Services by Age Band Relationship Age Range Preventive Basic Major Ortho Total % of Total Employee 24 & Under 772 280 18 0 1,070 1.1% 25 to 34 11,008 2,560 208 0 13,776 14.1% 35 to 44 11,841 1,972 359 0 14,172 14.5% 45 to 54 13,621 2,217 528 0 16,366 16.7% 55 to 64 18,038 2,907 968 2 21,915 22.4% 65 & Over 24,362 4,465 1,698 0 30,525 31.2% Totals: 79,642 14,401 3,779 2 97,824 Spouse 24 & Under 99 36 2 0 137 0.3% 25 to 34 3,231 862 70 0 4,163 10.6% 35 to 44 4,982 959 137 0 6,078 15.5% 45 to 54 5,389 983 253 0 6,625 16.9% 55 to 64 8,067 1,496 526 0 10,089 25.7% 65 & Over 9,786 1,806 630 0 12,222 31.1% Totals: 31,554 6,142 1,618 0 39,314 Children 0 to 5 6,704 379 26 0 7,109 12.5% 6 to 12 20,000 1,600 3 0 21,603 38.1% 13 to 18 13,936 1,849 24 2 15,811 27.9% 19 to 23 6,914 1,748 62 0 8,724 15.4% 24 & Over 2,563 793 48 0 3,404 6.0% Totals: 50,117 6,369 163 2 56,651 Grand Total 161,313 26,912 5,560 4 193,789 Aggregate Totals Children 50,117 6,369 163 2 56,651 29.2% 24 & Under 871 316 20 0 1,207 0.6% 25 to 34 14,239 3,422 278 0 17,939 9.3% 35 to 44 16,823 2,931 496 0 20,250 10.4% 45 to 54 19,010 3,200 781 0 22,991 11.9% 55 to 64 26,105 4,403 1,494 2 32,004 16.5% 65 & Over 34,148 6,271 2,328 0 42,747 22.1% Totals: 161,313 26,912 5,560 4 193,789 10 01/08/2017
Paid Claims By Age Band Relationship Age Range Preventive Basic Major Ortho Total % of Total Employee 24 & Under $46,075 $37,509 $7,380 $0 $90,964 1.2% 25 to 34 $603,511 $322,513 $84,527 $0 $1,010,550 13.3% 35 to 44 $635,242 $233,811 $161,094 $0 $1,030,147 13.6% 45 to 54 $734,195 $271,889 $229,073 $0 $1,235,157 16.3% 55 to 64 $958,229 $353,807 $411,986 $0 $1,724,021 22.7% 65 & Over $1,272,810 $518,011 $700,004 $0 $2,490,825 32.9% Totals: $4,250,062 $1,737,53 $1,594,063 $0 $7,581,664 Spouse 24 & Under $5,967 $5,526 $578 $0 $12,071 0.4% 25 to 34 $177,527 $104,547 $28,385 $0 $310,459 10.1% 35 to 44 $264,671 $110,116 $61,529 $0 $436,317 14.2% 45 to 54 $280,973 $123,780 $105,896 $0 $510,649 16.6% 55 to 64 $414,313 $179,845 $226,073 $0 $820,231 26.7% 65 & Over $502,282 $216,044 $260,559 $0 $978,886 31.9% Totals: $1,645,733 $739,859 $683,020 $0 $3,068,613 Children 0 to 5 $329,178 $39,223 $5,110 $0 $373,511 11.2% 6 to 12 $937,391 $142,666 $939 $0 $1,080,995 32.3% 13 to 18 $713,349 $244,037 $10,751 $0 $968,136 28.9% 19 to 23 $394,128 $249,413 $25,135 $0 $668,676 20.0% 24 & Over $137,591 $100,061 $20,043 $0 $257,695 7.7% Totals: $2,511,636 $775,400 $61,977 $0 $3,349,013 Grand Total $8,407,431 $3,252,79 9 Aggregate Totals $2,339,060 $0 $13,999,28 9 Children $2,511,636 $775,400 $61,977 $0 $3,349,013 23.9% 24 & Under $52,042 $43,035 $7,958 $0 $103,035 0.7% 25 to 34 $781,038 $427,060 $112,911 $0 $1,321,009 9.4% 35 to 44 $899,913 $343,927 $222,623 $0 $1,466,464 10.5% 45 to 54 $1,015,168 $395,670 $334,969 $0 $1,745,807 12.5% 55 to 64 $1,372,541 $533,652 $638,058 $0 $2,544,251 18.2% 65 & Over $1,775,092 $734,056 $960,563 $0 $3,469,711 24.8% Totals: $8,407,431 $3,252,79 $2,339,060 $0 $13,999,28 11 01/08/2017
Total Paid Claims Month Regular Claims Orthodontic Claims Paid Claims # of Employees Average Claims Per Employee Jan-2016 $1,133,346 $0 $1,133,346 23,487 $48.25 Feb-2016 $1,135,835 $0 $1,135,835 23,493 $48.35 Mar-2016 $1,336,269 $0 $1,336,269 23,465 $56.95 Apr-2016 $1,160,665 $0 $1,160,665 23,398 $49.61 May-2016 $1,104,061 $0 $1,104,061 23,343 $47.30 Jun-2016 $1,375,558 $0 $1,375,558 23,383 $58.83 Jul-2016 $1,064,311 $0 $1,064,311 23,371 $45.54 Aug-2016 $1,091,613 $0 $1,091,613 23,430 $46.59 Sep-2016 $1,195,203 $0 $1,195,203 23,361 $51.16 Oct-2016 $996,793 $0 $996,793 23,306 $42.77 Nov-2016 $1,063,660 $0 $1,063,660 23,362 $45.53 Dec-2016 $1,341,978 $0 $1,341,978 23,321 $57.54 Total $13,999,289 $0 $13,999,289 280,720 $49.87 12 01/08/2017
Enrollment by Member Type Month Total Employees Employee Only Employee With Dependents Total Spouses Total Children Total Members Members Per Employee Jan-2016 23,487 11,412 12,075 9,550 13,183 46,220 1.97 Feb-2016 23,493 11,458 12,035 9,491 13,097 46,081 1.96 Mar-2016 23,465 11,464 12,001 9,488 13,048 46,001 1.96 Apr-2016 23,398 11,427 11,971 9,464 13,018 45,880 1.96 May-2016 23,343 11,387 11,956 9,457 12,998 45,798 1.96 Jun-2016 23,383 11,423 11,960 9,455 12,976 45,814 1.96 Jul-2016 23,371 11,442 11,929 9,427 12,944 45,742 1.96 Aug-2016 23,430 11,468 11,962 9,454 12,967 45,851 1.96 Sep-2016 23,361 11,444 11,917 9,418 12,869 45,648 1.95 Oct-2016 23,306 11,432 11,874 9,398 12,764 45,468 1.95 Nov-2016 23,362 11,479 11,883 9,407 12,786 45,555 1.95 Dec-2016 23,321 11,468 11,853 9,385 12,747 45,453 1.95 Average per Month 23,393 11,442 11,951 9,450 12,950 45,793 1.96 13 01/08/2017