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Board approves $1.32 million dental stabilization buy-down; members urge action on shrinking Delta Dental network
Summary
The Health Service Board approved using one-third ($1.32 million) of the active dental PPO stabilization reserve to buy down 2026 rates. Members and commenters told the board they are losing Delta Dental-participating dentists and urged the system and carrier to address reimbursement and network access.
The San Francisco Health Service Board unanimously approved a stabilization reserve action on March 13 that will apply $1,320,000 — one-third of the December 31, 2024 stabilization fund balance for the self-funded active dental PPO — as a buy-down to 2026 rates.
Aon lead actuary Mark Clark presented the recommendation under the SFHSS stabilization fund policy. Clark explained the calculation: the stabilization surplus balance as of Dec. 31, 2024 totaled $3,960,000; per policy the board may apply one-third of the stabilization balance to rate buy-downs, which equaled $1,320,000 for the active dental PPO. He noted the plan’s stabilization balance grew from prior favorable experience and that $2,640,000 would remain for future rating periods after the 2026 buy-down.
Commissioners discussed long-running concerns about Delta Dental network adequacy and provider reimbursement. Commissioner Sass and others said they have heard repeatedly from members and providers that dentists are leaving the Delta Dental network because reimbursement levels are too low, which reduces in‑network access. Aon and SFHSS staff acknowledged the concern and said Delta Dental representatives would be asked to present at the April rates-and-benefits meeting to explain renewal proposals and network strategies.
During public comment, Fred Sanchez of Protect Our Benefits and other callers urged the board to investigate the number of dentists who have left Delta Dental over recent years and to press the carrier on network access. Sanchez said retiree members sometimes find the plan’s capitation and reimbursement structure unattractive to providers and questioned the value proposition for certain retiree enrollees.
Board members noted the stabilization action applies only to the self‑funded active dental PPO, because the other dental plans (insured HMOs and retiree dental plans) are fully insured and thus not subject to the stabilization policy. The motion passed unanimously by roll call.
Ending: Staff promised a deeper review of dental network participation and county-level utilization in the next meeting’s rate materials; the $1.32 million stabilization buy-down will be applied across active PPO rating tiers for 2026.
