Health solutions
Dental health
Dental actuarial issues are distinct and require specific expertise.
Dental actuarial issues are unique and require specialized knowledge, differing significantly from other lines of insurance, such as medical, disability, and supplemental health. Milliman has consultants who are recognized experts in the dental insurance market. We handle all dental markets, including commercial large and small group, individual, Affordable Care Act essential health benefits, Medicaid, and Medicare Advantage. We work with insurance companies of all sizes, governments, employer groups, provider groups, industry associations, health policy organizations, and startups to provide a range of dental consulting services.
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Milliman dental health solutions
Pricing and premium development
Milliman’s team of experts support premium rate development for a wide variety of clients and products, including commercial large and small group, individual, Affordable Care Act (ACA) compliant essential health benefits, Medicaid, and Medicare Advantage plans. Milliman curates and maintains vast databases that enable consultants to price new products and estimate the cost impact of benefit mandates, regulatory changes, and other external forces. Our consultants have experience in creating and certifying premium rate filings in all states and have a deep understanding of the unique regulatory and competitive landscape of each market.
Product development and competitive market analyses
Our consultants have extensive experience helping clients launch new products and enter new markets. We offer support related to dental insurance product design, ranging from defining covered services to designing cost- sharing structures and utilization controls to meet financial and strategic goals. We have assisted insurance carriers with the design of new products and the adaptation of existing product lines to new markets. We have decades of pricing and product development experience, supported by healthcare data, independent research, and proprietary tools.
Reserving
Our consultants have broad reserving experience specifically for dental products. We regularly assist clients with their reserving needs, including incurred but not reported reserve calculations, premium deficiency reserves and other reserve calculations, formal statements of actuarial opinion, and other appointed actuary support. Milliman also offers the Claim Reserve Estimation Workbook (CREW), a flexible Microsoft Excel-based model to estimate incurred but not reported (IBNR) liabilities. CREW’s primary asset is its ability to accommodate unusual claim payment patterns, as well as changing enrollments, benefits, unit costs, and other key factors like changes in capitation and provider contracts.
Employee benefits consulting
Our experts assist employer clients with managing their dental benefit, including private employers, public employers, and multi-employer pools. We offer comprehensive dental request for proposal (RFP) support services, including drafting RFP questionnaires, administering the RFP, evaluating bidder responses, conducting repricing analyses, and providing insights to assist in final vendor selection. We regularly assist plan sponsors with self-insured benefits to balance offering valuable benefits to employees while meeting financial goals, via plan design support, experience monitoring and benchmarking, annual budgeting and premium equivalent development, and periodic capital needs and reserve analyses.
Provider network and discount analyses
Our consultants routinely assist clients with dental provider network development and management, providing insight through analytic and strategic support. We have completed analyses to assess the breadth and depth of networks and produce benchmarks for discounts and provider reimbursement levels. We have assisted new insurance carriers with building a provider network and helped established carriers strategically expand existing provider networks. We have experience with developing provider fee strategies to expand access to care while controlling costs and meeting financial goals.
Data analytics and competitive information services
Milliman offers a comprehensive annual PPO network study for dental insurers. The analysis uses claims data provided by study participants and develops competitive market insights into PPO network discounts and network size for participants in the study. The results from the analysis are used to provide strategic insight into both a dental insurer’s own provider networks and the provider network landscape. Through this analysis, insurers are better able to understand their competitive network position and to address areas in which they want to compete or perform better.
Racial disparities in oral healthcare in the United States: Considerations in the COVID-19 era
This paper explores the racial disparities in the oral healthcare delivery system, found from the Healthy People 2020 plan.
Milliman dental health insight
Episode 21: COVID-19 and the implications on healthcare costs
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Actuarial consulting: Healthcare
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Benchmarking
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Health and welfare administration
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Health insurance exchange services
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Health, wellness, and disease management ROI
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Medicaid consulting for MCOs
Strengthen your Medicaid managed care program with expert experience review, budgeting support, market studies, and more.
Medicaid consulting for states
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Medicaid consulting services
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Mergers & acquisitions
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Product development and pricing: Healthcare
Make the right decisions when it comes time to enter a new market, launch a new product, or change benefits.
Milliman dental health products
Dental Actuarial Analytics (DAA)
Actionable insights for your dental network competitiveness
Health Cost Guidelines Suite
Estimate expected claims costs and model healthcare utilization with Milliman’s Health Cost Guidelines™, an industry gold standard.