Benefits administrator blog from Delta Dental

Tag: Delta Dental PPO

Take the mystery out of dental expenses with the Cost Estimator

Your employees are busy enough, so trying to figure out how to budget their dental care shouldn’t become a second job. That’s why we created the Cost Estimator, a tool available for desktop and mobile that your employees can use to estimate quickly and easily what their next dental visit will cost.

What’s more, the Cost Estimator has just been refreshed with a new, accessible and mobile-optimized design.

How can the Cost Estimator can help my employees?

The Cost Estimator provides employees with a personalized estimate (based on the fee schedule from the last dentist from whom they received service) for an entire dental visit with a specific dentist. It calculates employees’ out-of-pocket costs based on their current benefits. Information is updated daily, so your employees can always count on getting an accurate cost estimate.

This versatile and easy-to-use tool offers employees a variety of useful features and information to help them make the most of their benefits and helps them become better informed consumers.

In the tool, employees can choose from a list of common dental procedures ― they can even specify which tooth needs treatment or what type of filling they’d prefer! After they select their procedure, the Cost Estimator calculates their estimated out-of-pocket cost. The tool subtracts both the network savings and the portion the plan pays.

Other tasks your employees can perform with the Cost Estimator include:

  • Adding procedures. If employees need to add services such as a cleaning or x‑rays to their visit, they can add them to their estimate to get the total cost of the visit.
  • Comparing dentists. Employees might be curious to see if they’d save by switching to another dentist. The Cost Estimator lets them compare up to five in-network dentists to find the best deal.
  • Selecting plan members. Employees can get cost estimates for anyone on their plan, such as spouses and children.
  • Reviewing benefits usage. Employees can access the benefits activity and history for everyone on their plan, and can also review their plan’s maximums, deductibles and out-of-pocket limits.

How can the Cost Estimator help my bottom line?

The Cost Estimator provides members with transparency about their out-of-pocket costs. More cost transparency can mean fewer questions and less confusion about the value of visiting an in-network dentist. By showing the substantial cost differences between in-network and out-of-network dentist visits, the tool encourages in-network utilization — which can help members save and may help lower your group’s dental plan costs.

Is the Cost Estimator available to my group?

Yes! All Delta Dental PPO™ and Delta Dental Premier® groups are eligible to sign up for the Cost Estimator. Talk to your Sales contact to find out how to add this service to your plan.

DeltaCare® USA members receive a plan booklet with their copayments for covered services, so this tool isn’t necessary for DeltaCare USA plans.

To access the Cost Estimator, employees simply click Plan ahead for a visit from the member portal. PPO and Premier members can also access a more limited version of the Cost Estimator through the Delta Dental mobile app, which features in- and out-of-network fees.


With the Cost Estimator, your employees can be confident not only about staying within their budgets, but also that they’re getting the best deal for themselves and their families. Be sure your employees don’t miss out on this valuable resource.

Why leased networks don’t deliver

When it comes to dental coverage, having a large, dependable dentist network is crucial for quality dental care and reliable, cost-saving in-network access.

One of the unique advantages your employees enjoy with Delta Dental is network size. Our proprietary dentist networks are the nation’s largest. How large? Our combined Delta Dental PPO™ and Delta Dental Premier® networks feature more than 155,000 unique dentists, as of September 2021, according to Zelis Network360.

And to ensure quality care, we contract directly with each of our dentists and, most importantly, never lease our networks. That’s not the case with most other carriers, which lease dentist networks from other carriers to boost their numbers.

Of course, you might say to yourself, numbers are numbers ― if the network is large and my employees can visit a dentist, why does the type of network matter?

Because with leased networks, these numbers can be deceiving. What’s more, leased networks come with serious disadvantages for your employees.

To help understand some of these disadvantages, let’s first take a look at what leased networks are and how they work.

How leased networks work

A leased network arrangement is when one carrier agrees to share its dentist network, or a portion of it, with another carrier. A carrier can add one or many leased networks to their proprietary network.

A carrier can also share its network with a third-party insurance administrator, also known as an aggregator. Aggregators don’t own the insurance plans or pay claims. Instead, as the name suggests, aggregators lease networks from several carriers and offer participation to dentists for a fee.

Carriers profit from these arrangements by charging access fees for using their network. They may also profit from shared claim savings, which is an agreed-upon amount paid by an aggregator or carrier to the carrier whose dentist was visited to provide a service.

Leasing networks offers carriers several benefits. It allows them to expand into areas where they don’t have a network presence. It enables them to claim that they’ve increased their network size, which they can use to gain an advantage in the marketplace. And they stand to profit from access fees and shared saving.

However, these advantages for the carrier can mean disadvantages for your employees.

The downside of leased networks

Access fees

While carriers may benefit from access fees, your employees won’t. Carriers who lease networks often pass the cost of access fees on to self-funded groups by withholding claims savings. These fees can also differ from network to network.

We never charge access fees, so you can be sure your employees will get the full savings they’re entitled to.

Network size questions

Carriers that lease networks may claim that their network is “large.” But for these carriers, exactly how large can be a tough question to answer. Why? Carriers who lease networks usually have no direct contact with dentists. And since they may lease multiple networks, keeping track of dentists who leave a network, retire or fail credentialing can be a challenge. 

We update our dentist directory daily, so you know it’s accurate. And since we have relationships with our dentists, turnover is low.

Network lease timing

When you choose a dental benefits carrier, you’re locked in for the term of the contract. But that contract may not correspond to the carrier network’s lease agreements. Carrier-to-carrier leasing contracts are negotiable and can be terminated at any time. This means your employees might find the dentists they chose and depend on are suddenly no longer in their network. A leased network could lose thousands of dentists overnight.

Since we don’t lease networks, your employees can be confident knowing they can visit the dentists they know and trust.

Increased costs

When leasing contracts change, members’ expenses can increase. With renegotiated fees under a new lease, your employees may not realize their out-of-pocket costs are higher than expected until claims are processed. And these changes can happen at any time. 

That’s not the case with Delta Dental’s proprietary networks.

Inconsistent fees and billing

When a carrier leases several different dental networks, it can result in several different fee schedules, which can lead to inconsistent costs. Dentists may also be confused about how to bill enrollees, which could potentially increase the time it takes to process claims or even lead to incorrect billing. And since the leased networks are owned by different carriers, resolving any billing disputes may be difficult.

Our networks offer predictable, consistent fees and uniform billing and processing.

Quality concerns

Quality of care matters to patients and employers. But when a carrier leases multiple networks, this is difficult to guarantee. Since carriers have no relationship with the dentists in the networks they lease and contractual obligations around quality standards vary, they may not be able to confirm that these dentists’ treatment plans, safety measures and office cleanliness meet acceptable standards, nor can they guarantee that these dentists are properly credentialed.

At Delta Dental, we contract directly, maintain strong relationships and hold our dentists to high standards.


The promise of a carrier with a leased network may seem appealing, but that promise doesn’t hold up to scrutiny. With Delta Dental, you can be sure that you’ll get the network, quality and consistency that you — and your employees — can count on.

New videos help explain Delta Dental’s online tools and networks

With a new series of educational videos, it’s easy to help your employees understand their plans. Whether your organization offers Delta Dental PPO™, DeltaCare® USA or both, you’ll find useful resources to explain Delta Dental’s networks and online tools.

Get to know Delta Dental’s online tools

Encourage your employees to sign up for an online account. This video walks employees through the robust online tools Delta Dental offers, including plan details, claim history, personalized cost estimates, the online dentist directory and a wealth of wellness resources.

What if your group’s plan doesn’t include the Cost Estimator? No worries. This shorter version of the same video touches on the same helpful features, minus the personalized cost estimate.

Understand the Delta Dental networks

A PPO plan offers savings, quality assurance and simplicity. Through this video, your employees will learn the advantages of this plan and the steps for finding a PPO dentist online.

Want to expand your employees’ options with the Delta Dental Premier® network? This video introduces both the PPO and Premier networks and explain how to search for both in our dentist directory.

If you offer a DeltaCare USA plan, help your employees understand how this prepaid plan works and show them how to select a primary care dentist.

Ensure accessibility

These videos were designed with accessibility in mind. While the vibrant visuals support the narration, all key messages are conveyed in the audio, which can also be accessed through closed captioning.

Share the videos with your employees

To share these videos on your website or intranet, just click on the videos to navigate to YouTube. Below the video you wish to share, click on Share > Embed. Then copy and paste the code into your webpage or intranet site.

May the Fourth (of our PPO network) be with you!

On this fourth day of May, we’d like to remind you of the benefits of PPO network utilization — Star Wars style. May the network force be with you (and with your enrollees)!

First, we interviewed Yoda about the benefits of offering a PPO plan. He says, “To offer your enrollees a PPO plan because they have the freedom to choose any dentist, you probably chose. And with a Delta Dental PPO™ plan, offering secondary access with our Delta Dental Premier® network, you are.”

And he’s right — with Delta Dental PPO, more of your enrollees have an opportunity for moderate savings with a Premier dentist. (But they’ll usually save the most if they go PPO, which is why it’s important for enrollees to understand how to use their plan.)

Need some Jedi wisdom on your dental benefits? Here are some answers to common questions and some things for you (and your enrollees) to consider.

Network (and non-network) dentist visits: A battle scenario

Let’s say your enrollees are young Jedis about to battle skilled Sith warriors. In this scenario, the Sith warriors are the out-of-pocket costs of going to the dentist. So, have your enrollees choose a weapon.

  • No weapon means minimal protection — kind of like visiting a non-Delta Dental dentist. Your enrollees aren’t taking advantage of any of the network savings that your carrier is offering.
  • Using a lightsaber is nice, but your enrollees wouldn’t bring a lightsaber to a blaster fight, would they? This is moderate protection — like visiting a Delta Dental Premier dentist.
  • Finally, using a blaster is usually your enrollees’ most reliable form of protection. Like visiting a Delta Dental PPO dentist, they’re getting the most protection against Siths — er, out-of-pocket costs.

“What if my group has a PPO plus Premier plan design?” We thought you might ask. In that scenario, you’re offering your enrollees more protection against balance billing than you would be with a standard PPO plan, but they (and your group’s overall plan costs) will usually benefit most from going PPO.

Dental networks and finding a dentist

A dental plan is only as valuable as its network. That’s why we’re proud to offer expansive, nationwide PPO access. If you think an army of storm troopers is a crowd, you haven’t seen our provider directory.

And your enrollees don’t have to go to Tatooine to find network savings — tell them to log in to our online services and use our Find a Dentist tool to find a PPO dentist near their home, office or any chosen location.

Encouraging PPO utilization 

You should talk with your employees about the benefits of in-network dentist visits, like more potential savings and more convenience with no claims forms.

In Yoda’s words, pass on what you have learned! Consider attaching this instructional flyer (PDF) to your next group email and encourage them to search only for PPO dentists. And remember — the force is strong with those who go PPO.


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Delta Dental PPO: Is your group part of the in-crowd?

2‑minute read

One of the best parts about choosing a PPO dental plan for your employees is giving them the freedom to choose any licensed provider for their next visit. And, with Delta Dental, you’re offering additional access with our Delta Dental Premier® network. With so many choices, it’s important to weigh the options.

Network utilization is a key aspect of your dental plan — because in-network visits could save you money or help stabilize your group’s plan costs over time. Some things to consider:

What does in-network actually mean?

If you currently offer a Delta Dental PPO™ plan, in-network visits always mean visits to PPO dentists. We’d like to say it’s that simple, but sometimes offering twice the freedom results in twice the questions.

What about Premier visits?

The Delta Dental Premier® network acts as a safety net for out-of-pocket costs, so enrollees usually save more than they would if they visited a non-Delta Dental dentist. However, the Premier network doesn’t offer the deep discounts that PPO can.

What if I offer a PPO plus Premier plan?

If your group offers a Delta Dental PPO plus Premier™ plan, or any plan in which non-PPO dentists are not reimbursed based on contracted PPO fees, enrollees will still save the most when they go PPO. The difference for these plans is how we calculate fees for claims. The plan still offers a safety net for non-PPO claims if enrollees visit a Premier dentist, and you’re offering them more balance billing protection if you choose a fee basis other than the PPO contract allowance for all claims.

How do I encourage PPO utilization?

Talk with your employees about the benefits of in-network dentist visits, like more potential savings and more convenience with no claims forms to fill out. You can also remind them to find a network dentist using our find a dentist tool. Consider attaching this instructional flyer to your next group email and encourage them to search only for PPO dentists.


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