Flawed ADA Report Misses the Mark on Value of Children’s Dental Benefits

by Lauren Oakley | Apr 21, 2016
Contacts: David Irwin, Delta Dental Plans Association
(630) 600.8236,        
Rene Chapin, National Association of Dental Plans  
(972) 458-6998 x 110,

Analysis of Consumer Spending & Costs is Misleading & Error-laden Say Lead Dental Industry Groups 

OAK BROOK, Illinois – A new report out from the American Dental Association’s (ADA) Health Policy Institute challenging the value of private dental benefits is drawing strong criticism from lead industry groups. The ADA report claims that consumers with children covered under private dental plans are spending more out-of-pocket on premiums and copayments than their benefits are worth. But the National Association of Dental Plans (NADP) and Delta Dental Plans Association (DDPA) say the report’s conclusion, based on cherry-picked data and uninformed assumptions, is fundamentally flawed. 

While the report claims its findings apply to all private dental benefits, it relies on pricing and related data for children with standalone dental benefits purchased inside the Public Exchanges created by the Affordable Care Act (ACA) representing less than one percent of the dental plans Americans purchase. Despite this, the study authors’ state, “we feel our analysis is very relevant for group dental plans purchased outside of the ACA marketplaces.” But, they’ve got the facts and the numbers wrong, according to DDPA and NADP, reflecting a basic misunderstanding of the dental benefits industry.

  • The majority of Americans with private dental insurance get it through their employers (92%) as a group plan covering families. These plans are vastly different from the individual children’s plans required to be sold in the ACA’s Public Exchanges, and cost much less. As a result, the average premium cited in the ADA report inflates employer-sponsored premiums by 18% on average. This alone renders false the report’s conclusion regarding premiums vs. market value of private benefits.
  • For the portion of the premium paid by employees for health benefits, including dental, they use pre-income tax dollars – which drives down the out-of-pocket cost of premiums by another 20% (the average tax advantage of a pre-tax purchase). The ACA plans, which the report cites for the average premium, are paid for with income Americans have already been taxed on. 

The average premium identified in the ADA report is $381. After taking into account just these two key adjustments needed to correct the analysis, using claim cost data provided by the nationally recognized experts at Milliman, the average annual premium for private dental benefits for children ages 1-6 would be $240, and $254 for ages 7-18 – which means that the premiums used in the ADA’s report are inflated by about 34%.

“The ADA Health Policy Institute has done some excellent economic analysis on pressing issues for dentistry. When the Institute ventures into areas of coverage, particularly private market coverage, however, they simply don’t have the needed expertise to accurately present the cost of coverage for the consumer,” said Evelyn Ireland, executive director for the National Association of Dental Plans. “In this instance, that lack of expertise lead to a grossly inaccurate conclusion. Unfortunately, that conclusion might be accepted without question on the strength of their other reports. With consumer research showing that Americans with dental benefits see the dentist twice as often as those with no coverage, a false conclusion about the value of dental benefits could result in both a reduction in coverage and reduced dental care for children—a result that neither our industry nor the ADA want.”

“Delta Dental has a long and positive track record of working with the ADA, but a main conclusion reached in this report is simply wrong, hampering the rest of the research,” said Steve Olson, president & CEO of Delta Dental Plans Association. “We agree with the report’s authors that many children are missing out on necessary cleanings and exams, and perhaps other needs. Children’s access to, and utilization of, oral health care is an issue Delta Dental is dedicated to addressing across the nation. It is essential that parents, advocates and dental care providers have accurate information in order to tackle it the right way.”

About National Association of Dental Plans

National Association of Dental Plans (NADP), a Texas nonprofit corporation with headquarters in Dallas, Texas, is the “representative and recognized resource of the dental benefits industry.” NADP is the only national trade organization that includes the full spectrum of dental benefit companies operating in the United States. NADP’s members provide Dental HMO, Dental PPO, Dental Indemnity and Discount Dental products to more than 188 million Americans, representing over 92 percent of all Americans with dental benefits, through both employer-provided private coverage and public programs like Medicaid and CHIP.

Follow us on Twitter @nadp_consumers.  Like us on Facebook. 

About Delta Dental Plans Association

The nonprofit Delta Dental Plans Association, based in Oak Brook, Illinois, is the national association of Delta Dental member companies, which collectively make up the nation’s leading dental benefits provider, with enrollment of 68 million Americans. For more information, visit our website at

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