Board approves 2026 dental rates amid public outcry over dentists leaving Delta network

The San Francisco Health Service Board on Thursday approved the recommended 2026 dental rates and administrative arrangements after public commenters and union representatives urged more action to address dentists leaving the primary Delta Dental network. The board vote to adopt the rates passed 4‑1. Commissioner Kremen cast the lone dissenting vote.

What the board approved: Mike Clark of Aon detailed the staff recommendation: maintain the active‑employee PPO administrative (ASO) fee at $4.82 per employee per month; apply a 12.4% increase to the self‑funded active PPO total cost rates for plan year 2026 driven primarily by a reduction in the prior rate stabilization buy‑down; extend coverage of first‑molar sealants for children through age 15; adopt a 2% premium increase for the fully insured retiree PPO plan; and keep the two HMO dental plans’ rates unchanged for 2026. Clark told the board the active PPO 12.4% increase is not driven by utilization growth alone but largely reflects drawing down rate stabilization that had subsidized prior years.

Network concerns and member testimony: The meeting included extended public comment from retirees and union representatives who described difficulty finding in‑network dentists and said dentists often require large out‑of‑pocket payments when members see a preferred dentist who has left the network. Fred Sanchez of Protect Our Benefits asked the board to hold a longer, dedicated forum on dental network issues. Anahita Falla of Local 21 told the board that members face either switching dentists repeatedly to remain in network or paying substantial out‑of‑pocket costs; she asked the city to consider stronger out‑of‑network protections if Delta does not improve access. Several speakers said they pay a large share of the bill even when enrolled in the dental plan.

Carrier response and data: Delta Dental representatives acknowledged the trend of provider terminations is national, not unique to San Francisco, and said the carrier is recruiting new providers and expanding outreach. Delta presented data showing a moderate number of providers who previously served SFHSS members left Delta’s PPO network in recent years, and that newly contracted dentists have been added — but members’ experiences vary by county. Delta said common termination reasons include retirement, practice consolidation or moves into insurance‑independent care models. Delta’s vice president said the company is contacting providers and rolling out targeted member communications and tools to help members find alternative in‑network providers.

Cost alternatives considered and rejected: Staff presented a modeled cost: making the retiree PPO out‑of‑network benefit mirror the active‑employee premier network tier would increase plan costs by about $1.88 million; staff did not recommend that change at this time. Clark told the board that a third of the stabilization fund balance was applied in 2026 per the board’s stabilization policy.

Vote and next steps: The board approved the rates and plan changes by roll call (4 yes, 1 no). President Howe and Vice President Zavansky both indicated reluctance but supported the recommendation; Commissioner Kremen voted no. SFHSS staff said they will pursue a pre‑analysis with Aon this summer to compare networks and claims handling across alternative carriers and will report back to the board during the fall review and potential RFP planning cycle.

Sources: Staff presentation and rate exhibits by Mike Clark (Aon), public testimony from Protect Our Benefits and Local 21, and remarks from Delta Dental representatives (Pete Anderson, Joanna Campos).