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We want to share an important update regarding the ongoing mediation process authorized under SSB 5351 during the most recent legislative session.
What is SSB 5351?
SSB 5351 created a formal mediation process to address long‑standing concerns with dental insurance networks, reimbursement rates, and administrative processes—issues that have affected both dentists and denturists. While the bill originated from the Washington State Dental Association’s (WSDA) concerns with Delta Dental, denturists were included due to shared challenges with Delta Dental and other insurers.
Recognizing the complexity of these issues, the Legislature engaged the William D. Ruckelshaus Center at Washington State University, an organization designed to help facilitate constructive dialogue around difficult public policy issues.
Who Is Participating?
This mediation process includes a broad range of stakeholders:
- Washington State Dental Association (WSDA)
- Denturists
- Delta Dental and Blue Cross
- Association of Washington Health Plans
- Consumer and patient advocacy groups
- Other dental professions (including maxillofacial surgeons)
- Business “purchasers” from both large and small employers
- Washington State Office of the Insurance Commissioner
Goals of the Mediation
Per the legislation, the collaborative is tasked with:
- Facilitating discussion around a dental loss ratio (DLR)
- (Medical plans currently have loss ratio requirements; dental plans do not.)
- Reviewing relative payment issues for dentists and denturists based on provider network status, including payment methodologies such as usual and customary rates.
- Developing recommendations for potential legislative or regulatory action.
The group will issue regular reports to the Legislature, with a final report due June 30, 2026. These reports will also be made available to WDA members.
Progress So Far
Two meetings have been held to date:
- First Meeting:
- Focused on introductions, establishing ground rules, and ensuring all necessary stakeholders were represented. Initial discussions began on whether implementing a dental loss ratio could benefit providers, consumers, and insurers.
- Second Meeting (November 21):
- Finalized ground rules and continued in‑depth discussion on dental loss ratios, including review of current premium and spending data from dental plans. Each stakeholder group also gave a 10‑minute presentation outlining their experiences and concerns.
- Carol Carbone of Lilly Denture Center provided an excellent overview of how insurance systems currently affect denturists and the challenges they face.
- Delta Dental acknowledged the need to improve collaboration with denturists and identified opportunities to better support their participation in the system.
What’s Next?
More substantive discussions are expected over the next several meetings, along with the creation of targeted work groups to address specific issues. Importantly, the process operates entirely by consensus, meaning all parties must agree on any recommendations put forward.
While not every issue may be resolved, this marks the most productive and collaborative dialogue ever held in Washington’s dental insurance landscape—and a shift toward problem‑solving rather than confrontation.
Stay Informed
New materials are now available on the Ruckelshaus Center website, including:
- November and December meeting summaries
- January 30 meeting agenda
- Dental Loss Ratio (DLR) presentation slides from the ADA Health Policy Institute
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