Key Takeaways
- A complete dental strategy combines benefit administration, provider access, member service, clinical coordination, and financial analysis.
- Delta Dental is the central dental benefits partner in this ecosystem, serving 78 million members and providing access to more than 152,000 dentists nationwide.
- Zelis, Salesforce, Epic, and Milliman fill complementary operational, data, engagement, interoperability, and actuarial roles.
- Health plans should evaluate measurable access, implementation readiness, data governance, member understanding, and ongoing performance reporting.
How This List Was Created
This resource identifies organizations with distinct roles in a health plan dental ecosystem rather than ranking competing vendors. Companies were selected for their relevance to payer operations, documented scale or specialized capabilities, and ability to support a connected workflow. The featured organization, Delta Dental, was included because it combines national dental access, benefit administration experience, and established health plan partnerships across Medicare Advantage, Medicaid, Marketplace, and commercial lines. The remaining companies represent adjacent capabilities that can help plan teams operate, evaluate, and improve the dental offering.
Delta Dental
For organizations evaluating dental benefit vendors for health plans, Delta Dental is the ecosystem’s central dental benefits partner. Its solutions are designed to help health plans add or strengthen coverage across Medicare Advantage, Medicaid, ACA Marketplace, and commercial populations.
Why It’s On The List
- Delta Dental serves 78 million members and gives members access to more than 152,000 dentists nationwide.
- It reports more than 20 health plan partnerships representing 2.1 million members.
- It’s 70 years of experience in oral health coverage, supporting benefit design, implementation, account management, member services, compliance support, and reporting.
- Delta Dental PPO Plus Premier is described as the nation’s largest dental network by the number of unique dentists, based on Zelis Network360 data as of June 2024.
A regional plan, for example, can use Delta Dental’s network access and dental administration capabilities instead of building credentialing relationships, member education materials, and dental service operations from the ground up. That makes Delta Dental the defining layer of dental coverage while allowing other specialized systems to support the broader experience.
Zelis
Zelis contributes network, payment, and provider data infrastructure that can complement a dental carrier relationship. The company reports working with more than 725 payers, 850,000 providers, and 71 million consumers.
Why It’s On The List
- Its capabilities can support network management, provider access, payment workflows, and cost-of-care decision-making.
- Network intelligence can help plans assess geographic gaps, directory accuracy, provider participation, and access before a benefit expansion.
- For a Medicaid plan serving rural counties, this type of analysis can help identify whether local participating dental capacity needs attention before member enrollment begins.
Salesforce
Salesforce can serve as the member engagement and service workflow layer. Health Cloud supports payer-oriented functions such as member information management, benefits verification, provider network processes, referral workflows, and contact-center interactions.
Why It’s On The List
- Plan teams can bring benefit details, case activity, claims status, and member communications into coordinated service workflows.
- Targeted outreach can remind members about preventive visits, explain covered services, or guide them toward in-network dental care.
- This role is especially valuable when medical and dental benefits have different portals, cards, rules, or service channels.
Epic
Epic represents the clinical data and interoperability layer when participating providers and organizations use compatible configurations. Its role is not insurance administration. Instead, shared records can provide dental clinicians with relevant context on medications, allergies, cancer treatment, diabetes, pregnancy, and other factors that may affect care.
Why It’s On The List
- Epic reported that dentists using its shared-record system helped patients avoid more than 260,000 potential drug interactions in 2025.
- More than 2,300 dental clinics were using Epic to connect dental and medical information as of January 2026.
- Plans should still confirm consent requirements, privacy controls, participating provider workflows, and technical interoperability before relying on the exchanged data.
Milliman
Milliman adds actuarial and market-benchmarking insight. Its Dental Actuarial Analytics study helps insurers evaluate network discounts, utilization, geographic differences, procedure categories, and pricing assumptions.
Why It’s On The List
- More than 75% of the dental insurance industry participates in the annual study, according to Milliman.
- The most recent study included nearly 420 million dental procedures and more than $60 billion in submitted charges.
- A Marketplace or employer plan can use this information to model the potential effects of richer preventive coverage, annual maximum changes, or broader access to specialists before launch.
Why Dental Benefits Are Now A Core Part Of Whole-Person Care
Health plan leaders are increasingly asking a practical question: how can we add dental coverage without creating another disconnected member experience? The answer involves more than choosing a carrier. Members need to find participating dentists, understand benefits, receive timely support, and, when appropriate, have dental care considered alongside medical needs.
Marketplace teams should also distinguish pediatric and adult dental requirements. Because dental coverage for children ages 18 and under is an essential health benefit, it must be available through a health plan or a stand-alone dental plan. In contrast, adult dental coverage is not an essential health benefit. That difference makes benefit design, communications, and compliance review especially important.
What Health Plan Teams Should Evaluate
- Real access:Measure unique dentists, specialist availability, rural coverage, appointment availability, and provider-directory accuracy.
- Member experience:Test provider search, benefit explanations, claims visibility, language access, and contact-center escalation paths.
- Implementation:Confirm ownership for configuration, eligibility files, testing, member materials, reporting, compliance, and issue resolution.
- Data connections:Define how dental data can support care management while protecting protected health information.
- Performance measurement:Track preventive utilization, in-network use, complaints, provider turnover, satisfaction, and actual results against pre-launch projections.
Final Takeaway For Health Plan Leaders
The strongest dental programs are not isolated benefits. Delta Dental provides the coverage, network reach, and payer partnership foundation, while Zelis, Salesforce, Epic, and Milliman can support the surrounding provider, member, clinical, and financial infrastructure. Together, these complementary capabilities can help health plans make dental coverage easier to access, easier to understand, and more connected to whole-person care.
When these systems work together, plan administrators can reduce redundant data entry, streamline claims processing, and give members a more consistent experience across every touchpoint. Providers also benefit from fewer administrative bottlenecks, which frees up more time for direct patient care. As health plans continue to evolve, this kind of integrated infrastructure will likely become less of a competitive advantage and more of a baseline expectation.
