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Consultant says Delta Dental likely to reduce out‑of‑pocket costs compared with current state MetLife plan
Summary
Gallagher presented a comparison of dental plans after employee complaints: consultant estimated Delta Dental would process ~95% of local claims in‑network versus MetLife ~60%, and said a switch could reduce members' total out‑of‑pocket costs; no board decision was made tonight and August 1 is the state notice deadline.
Gallagher, the district’s benefits consultant, briefed the Rutherford County Board of Education on dental coverage options after employee complaints about access under the state’s MetLife PDP plan.
Wes Doer of Gallagher said a Delta Dental dual‑plan option would likely return many members to in‑network coverage: his analysis estimated Delta would process roughly 95% of district and surrounding zip‑code claims in‑network, while MetLife’s PDP network processed an estimated 60% in‑network. Gallagher told the board that when out‑of‑pocket point‑of‑service payments are added to monthly deductions, the aggregate financial burden on members is higher under the MetLife arrangement in the district’s current utilization patterns.
Gallagher estimated average member monthly deductions under Delta at about $68.25 (plan‑level average) versus an aggregate per‑member average of about $74.17 when MetLife monthly cost is combined with typical point‑of‑service balances; the presenter said those figures show comparable or lower total member costs with Delta when network effects are considered. He noted the state plan offers a narrow DHMO low option that some employees select for lower premiums but then face limited provider access.
Board members asked questions but did not take action. Staff said August 1 is the deadline to notify the state if the district chooses to opt out of the state dental plan; the topic will return to a future meeting for additional discussion and comparison with the state's options.
Next steps: staff will present a comparative table including the state plan at a subsequent meeting and the board may consider a recommendation ahead of the August 1 notice deadline.
