September 1, 2017
OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler has ordered Dental Health Services to fix its network of providers by Oct. 30 following an investigation of complaints from enrollees.
The company, headquartered in Long Beach, Calif., is the second-largest insurer of dental services in the state. It has more than 52,000 enrollees, including just over 14,000 signed up through the Washington Health Benefit Exchange. It is the largest dental insurer in the Exchange.
Kreidler’s office investigated multiple complaints and a review of dental provider contracts. The findings:
- Inadequate network of dental providers. Kreidler’s office reviewed 273 company contracts with dentists and found a provider network that is currently inadequate to serve patients. The company itself reported in July that eight of 10 contracted dentists were no longer accepting new patients. Kreidler’s office monitors provider networks for health insurers, including those that offer dental plans. This is done to ensure companies meet anticipated consumer needs.
- Lack of alternative access plan. Despite requests from Kreidler’s office, the company has been unable to provide assurance that it can guarantee access to general dental care for 170 enrollees and specialty care for over 1,400 enrollees.
“The company is failing to honor its promise of service to consumers who are paying premiums,” Kreidler said. “We have serious concerns about the company’s ability to meet its obligations.”
Kreidler’s office has worked with company representatives over the last several months to try to resolve the emerging concerns. On Aug. 30, Kreidler set a 60-day timeframe for the company to submit a plan to resolve the outstanding issues. The plan is due Oct. 30.
“Our goal is for Dental Health Services to improve its operations to serve consumers as promised,” Kreidler said. “We are doing everything in our power to help the company turn this around.”
Kreidler’s office has scheduled a meeting with company representatives Sept. 7 at the insurance commissioner’s office in Tumwater to further discuss resolution to current issues.
Consumers in Washington state can file insurance-related complaints with Kreidler’s office.