2014 Annual Report

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2014

Annual Report

2014 nadp annual report

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Contents

table of c ontents

LEADERSHIP Board of Directors

research 4

Chair Chris Swanker Guardian Life Insurance

education 5-6

Vice Chair Theresa McConeghey Principal Financial Group

standards & transaction initiative government relations

Secretary Dr. Gene Sherman Starmount Life Insurance

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8-9

financial reports

10-11

Treasurer Kirk E. Andrews UnitedHealthcare Dental

Stacia Almquist Assurant Employee Benefits

volunteer excellence 12-13

Charles Brody Blue Cross Blue Shield of SC

star awards 13

gabryl award 12

don mayes award 12

staff contact information

Mark Coyne Dental Select

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Dr. Daniel Croley Delta Dental of CA, NY, PA & Affiliates

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Kate McCown Ameritas Life Insurance Corp.

Evelyn F. Ireland, CAE NADP Executive Director 2

2014 nadp annual report 2

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from the Chairman of the Board

Our member companies spent countless hours of preparation, spanning multiple disciplines ranging from system upgrades to federal lobbying, to set the stage for 2014 – the year that ushered in massive change for the entire health care industry and created unique challenges for our members.

In the midst of all this change, NADP shined. NADP responded to our members’ needs by creating and implementing new programs and services designed to help them succeed. In addition, the association continued to serve as the dental benefits industry’s recognized and representative resource on a variety of fronts.

In response to member needs, NADP launched two new programs: the Standards and Transaction Initiative plus Member Interest Groups.

Standards and Transaction Initiative (STI) At the close of 2013, NADP announced the creation of the Standards and Transaction Initiative (STI) to enhance usage of electronic data interchange (EDI) in response to sweeping changes in the way dental benefits are provided.

The STI consists of four workgroups (WGs) including Codes, Clinical, Operations and EDI. The first three groups replaced former volunteer groups while EDI was newly created to give NADP a clearer and stronger voice relating to EDI implementation issues under the Affordable Care Act. Member Interest Groups (MIGS) Via discussion in the CONVERGE attendee forum of Dental Interact, NADP learned of members’ desire to connect with others with similar interests, such as dental actuaries. In response to this need, NADP introduced Member Interest Groups (MIGS) in November. Through MIGs, groups of members with similar concerns may network online through Dental Interact discussion groups and also have meeting space at CONVERGE. The NADP core services of advocacy, education and research also continued to thrive in 2014.

Advocacy Highlights One of the most impactful advocacy initiatives of 2014 was NADP’s coordinated industry response and collaboration with the California Association of Dental Plans on loss ratio legislation in the state. Thanks to the response from our member companies, NADP provided key data that allowed us to present informed and persuasive points regarding impact to the dental benefits industry and consumers. Because NADP successfully presented a strong analysis of the industry, a dental loss ratio was turned into a loss ratio study.

Education Highlights Once again the industry turned to NADP for its professional development and networking needs. CONVERGE 2014 delivered in a big way, with record attendance and an impressive lineup of speakers and topics. In addition, the newly revamped exhibit hall - the Discovery Zone - provided additional value for both attendees and exhibitors in identifying products and services to meet operational needs.

Research Highlights Serving as your authoritative industry resource, NADP Research delivered its standard reports, fielded another wave of employer research, and provided significant support on advocacy issues including the California Dental Loss Ratio bill and Premium Tax Credits.

In addition to these accomplishments, NADP achieved 100% retention of our dental plan and associate members.

All of these factors positioned the association for continued, future success.

Chris Swanker, FSA, MAAA, NADP Chair Guardian Life Insurance

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Your Recognized Resource

NADP continued to provide members with knowledgeable industry insights through a robust library of research reports and CONVERGE presentations.

As the authoritative resource on the dental benefits industry, the following NADP Research Reports provided a broad industry perspective of the dental benefits market: • Metrics Reports: In conjunction with LIMRA, NADP published three metrics reports: Claims Processing, Customer Contact Center and Administrative Processes.

• Sales Reports: Also in conjunction with LIMRA, NADP made the quarterly sales reports available to participating members.

• Enrollment: The Delta Dental Plans Association (DDPA) partnered with NADP to deliver the Enrollment Report to dental plan members in August 2014.

• Network Statistics: Also in coordination with DDPA, in September 2014, NADP published the Network Statistics Report. For the fifth year, this report requested the actual provider database managed and maintained by each participating company. As a result of this methodology, all dentists participating in a provider network have been counted individually. Thus, the outcome is a census of all dentists participating on any provider network rather than an estimate.

• Premium Trends: NADP implemented dramatic changes to the Premium Trends Report in 2011.

This report no longer reports new premium trends, but is limited instead to in-force premium trends for DHMO, DPPO and Dental Indemnity products.

• Shared Research: NADP continued with a multi-wave survey of employers to assess their knowledge of ACA and how it will affect their business and to track their actions related to health and dental insurance as the ACA’s SHOP exchanges were implemented. The original schedule for this study was modified because of the delay in SHOP exchange implementation. The final two waves were scheduled for February 2015 and May/June 2016.

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2014 nadp annual report

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NADP provided dynamic educational content via CONVERGE and the Webinar Series.

nadp conference 2014

With record breaking attendance, CONVERGE 2014 offered timely topics in three educational tracks: ACA Implementation, Professional Relations and Sales and Marketing. The conference also revamped the exhibit hall and gave it a new brand, the Discovery Zone. Attendees remarked favorably on both the educational content and the Discovery Zone:

ere w s sion nt for s e S “ leva tate e r y ts ver n e r r u ” the c industry. r of ou

The D lot o iscove to b f foot tr ry Zone e a be w the pr ffic … “had a s im ses hen pe ary lo eemed sion o c s.” ple we ation t o re n The Discovery ot in Zone was so

energetic! ions s s e ut s o this k l a u e f r r “B nde o d on w e s e r u we foc are d n s r a o , r y yea s pa e u s g.” the is tly facin en pres nadp.org

The k ey really note spea k k and p new their ers st re mate sented th uff ria eir comp l in a elling mann er.”

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Your Recognized Resource

The 2014 Webinar Series offered something for everyone. Topics included:

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Dental Benefits in the Health Insurance Marketplaces, presented by Dr. Marko Vujicic, American Dental Association

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The Onset of Private Health Insurance Exchanges, presented by Scott Brown, Accenture

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How to Get Your Boss to Listen to Your Great Ideas presented by Larry Marks, professional speaker

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Oral and Overall Health Connections, presented by Dr. Stephanie Lepsky, OptumInsight

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Dental Spending and Services Utilization presented by Dr. Marko Vujicic, American Dental Association

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Improving Claims Accuracy, presented by Dr. Linda Vidone, DentaQuest; Eric Kirnbauer, Tesia; Michael Lessila, WonderBox; and

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Checking in on Dental and the ACA’s Health Insurance Marketplaces, presented

by Andy Snyder and Rachel Dolan, National Academy for State Health Policy

An Informatics Approach to Data Analytics in a Changing Dental Landscape, presented

by Dr. Franklin Din, Zigron Healthcare

How do dental networks on the exchanges compare to non-exchange dental networks? presented by Aaron Groffman, The Ignition Group

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LinkedIn: How the Next Generation of Social Networks Can Work for You, presented by Dean DeLisle, professional speaker

Brad Royer, Dentrix

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Your Representative The newly created Standards and Transactions WorkGroups adopted the following mission statements and structure: Clinical • Review and comment on current and proposed dental quality measures • Support for NADP voting seats on Dental Quality Alliance (DQA) and DQA Executive Committee • Review and comment on proposed guidelines and standards for disease management in the dental arena from dental specialty groups and the American Dental Association (ADA); i.e. radiation, sealants, pediatric dentistry, etc.

• Review and comment on current and proposed collaborative efforts to develop quality initiatives within state and federal programs; i.e. Centers for Medicare and Medicaid Services (CMS), state Medicaid, etc.

Codes • Coordination of concepts and terminology between procedure codes (CDT), diagnosis codes (SNODENT) and EHR reporting (ICD) • Develop, review and comment on proposed changes to procedure, diagnosis and reporting code sets • Support for NADP voting seats on ADA Code Maintenance Committee (CMC) and International Health Terminology Standards Development Organisation (IHTSDO) Dental Special Interest Group (Dental SIG).

Operations • Develop, review and comment on proposals for dental plan accreditation with accreditation organizations and federal representatives • Develop, review and comment on proposals for uniform credentialing within dental benefits organizations, providers and outside vendors • Serve as liaison to dental service organizations (DSOs) and the Association of Dental Support Organizations (ADSO) on initiatives of interest to both including credentialing, on-boarding and data sharing

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EDI (Electronic Data Interchange) • Review and comment on mandated EDI transactions including, but not limited to, claims processing, electronic funds transfer and electronic health records • Develop, review and comment on changes and updates in mandated EDI transaction on behalf of the dental benefits industry • Liaison with other state and national organizations engaged in the EDI arena • Support for NADP voting seats on Dental Content Committee (DeCC), Health Level 7 (HL7), Standards Committee on Dental Informatics (SCDI), Workgroup for Electronic Data Interchange (WEDI) and American National Standards Institute X12 (X12) including leadership positions on WEDI Dental Workgroup and X12 Dental Caucus Credentialing Subworkgroup With the goal of enhanced, streamlined processes for the dental industry, the NADP STI Operations Credentialing Sub-Workgroup met in Chicago during the first week of March to explore Dental Credentialing issues and come up with a detailed plan to move the industry forward; the specific goal is to reduce the time to access participating providers.

Nine NADP volunteers from across the country representing a mix of dental service organizations and payers attended along with two NADP staff members.

Four committees were formed to research different topics and report back to the Credentialing SubGroup and Operations Workgroup members: Core Data Set, Plan Policy, State and Federal Regulations and Time & Cost. The SubGroup published results of their deliberations and also presented at CONVERGE. Credentialing Next Phase The next step in the project is to pilot test use of the core credentialing form.

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Government Relations Your Representative

Four years after becoming law, the implementation of the Affordable Care Act (ACA) at federal and state levels continued to command NADP’s attention in 2014. And thanks to the dedicated work of NADP member volunteers and staff, the dental benefits industry saw many successes in 2014 on several key Advocacy issues and deliverables.

Affordability Ensuring consumer access to affordable dental benefits remained NADP’s top priority as evidenced by: • Leadership of industry stakeholders in the ongoing effort to urge the Internal Revenue Service (IRS) to change its calculation of Advanced Premium Tax Credits (APTC) to include the value of pediatric dental. NADP staff and member plans met with U.S. senators and representatives and IRS officials on separate occasions to share research on the impact of missing federal tax credits (APTC) for pediatric dental benefits in all states and potential paths to resolve the issue.

• Strong legislative and member campaign to mitigate impacts of a lower Maximum Out-ofPocket Limit (MOOP). Sens.

Warner, Begich, Grassley, Landrieu and Rep. Latham joined NADP in expressing concern about proposed MOOP levels, which were finalized as $350 (individual)/700 (family) instead of the proposed $300/$400.

• NADP’s Continued push for the Department of Health and Human Services (HHS) to allow the separate purchase of dental plans on Federally-facilitated Exchanges without the required purchase of

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a medical plan. NADP joined a group letter to HHS, led by a NADP member, which strengthened the arguments and demonstrated the sense of urgency felt by a varied list of oral healthcare stakeholders. These efforts bore fruit as the 2016 draft HHS Letter to Issuers indicates that HHS will allow the separate purchase of dental on the Federally-facilitated SHOPs. NADP applauds this step and will continue to work towards a parallel track on the Individual Exchanges.

• Collaboration with the California Association of Dental Plans (CADP) on the successful effort to educate and redirect the focus on dental loss ratios (DLR) in California. Collaboration efforts continued as NADP led the industry analysis to develop a simplified DLR reporting form with the CA Department of Managed Health Care and Insurance.

Exchanges As state Health Insurance Exchanges (now “Marketplaces”) continued to develop on their own or retreat to the federal model, NADP realized increased value from its newly renamed government relations volunteer groups: the Exchange Policy Workgroup (EPW), Exchange Technical Workgroup (ETW), Government Relations Workgroup

2014 nadp annual report

(GRW) and the Commission Advocacy Policy (CAP).

on

Within these groups, volunteers were able to share and discuss dental policies and engagement strategies – allowing the industry to come together through the strength of our members’ knowledge and contacts for successful outcomes within the states, particularly on dental issues in the District of Columbia, California and Connecticut Marketplaces.

The EPW continued to monitor Exchange developments and track the impact of policy decisions on the inclusion of dental benefits in state-based and federally-facilitated marketplaces.

The Workgroup actively engaged with several state Exchanges including New Mexico, Mississippi, New York and Idaho on issuer applications, offerings and deadlines, plan model language, and reasonable assurance.

In addition to the plethora of Marketplace issues and policies demanding attention, NADP also engaged with state officials on the allowance, structure and standards for dental plan certification in the small group and individual markets outside of Exchanges. Collaborating with the Life Insurance Council of New York (LICONY), and NADP members, the New York Department of Financial Services (DFS) authorized the issuance of Exchange-certified

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stand-alone dental plans off the Exchange by carriers that are not currently marketing on the Exchange. With this decision, New York joined a majority of states providing a clear path for dental plans to become Exchange/ Marketplace - certified in the private market.

Network Adequacy NADP and CAP actively monitored work by the National Association of Insurance Commissioners (NAIC) to update its “Health Benefit Plan Network Access and Adequacy Model Act,” attending weekly calls and seasonal in-person meetings.

In addition to the federal work, the GRW provided insight to regulators on the development of network adequacy standards in several states including Nevada and Washington, where regulators responded to NADP concerns about overly-broad application of standards for medical plans by narrowing the regulation to Exchange offerings and by adding additional clarification specific to dental.

Tools, Education and Outreach As the recognized voice of the dental benefits industry, NADP’s Government Relations department and members continued to engage industry-wide partners on various issues and initiatives. NADP released key analysis on inaugural Exchange enrollment in dental plans for industry partners and press, and continues to be called upon as the recognized dental benefits research expert.

As policymakers and advocates continued to focus more attention on the offer of dental benefits, NADP participated in several national discussions on oral health including an expert meeting on dental benefits and marketplaces hosted by the National Academy for State Health Policy (NASHP), which produced a comprehensive white paper on the subject with NADP input.

NADP staff also participated in the Federally-Facilitated Marketplace (FFM) Summit, a full day of updates and discussion on HHS IT priorities for the coming enrollment

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year, and a separate half day summit at the White House to discuss the FF-Small Business Health Options Program (SHOP). The GR Department will continue to monitor state and federal ACA implementation activities and with NADP members, actively engage policymakers on critical issues.

NADP informed members of these activities through a growing number of GR resources including: • • • • • •

NADP eNewsletters, Monthlybyte and Soundbytes Legislative Online Training System (LOTS) State Fact Sheets NADP webinars briefings, memos and member calls Updates in the GR and HCR Open Forums of Dental Interact (DI) “Advocacy Resources” webpage, which hosts numerous documents for member use, under the “Members Only” section of nadp.org

2014 Advocacy By the Numbers

3,400+ 300+

bills tracked in LOTS

GRW-Identified Priority Bills

Top Bill Issue Tags in LOTS: Exchanges

Government Health Programs

Provider Requirements

350+ 35+

HCR & Exchange Updates shared in Dental Interact (DI)

comment letters submitted by NADP on behalf of the industry.

Contact Us Today to get Involved!

2014 nadp annual report Eme Augustini • eaugustini@nadp.org

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Financial Report NATIONAL ASSOCIATION OF DENTAL PLANS (A nonprofit organization) Statements of Financial Position December 31, 2014 and 2013

2014 2013

ASSETS

CURRENT ASSETS

Cash & cash equivalents $ 1,722,950 $ 1,623,565

Restricted cash 21,331 16,356

Certificate of deposit 50,662 50,627

Accounts receivable 955,769 705,463

Prepaid expenses 40,937 48,269

Deposits 4,312 4,312

Total current assets 2,795,961 2,448,592

PROPERTY & EQUIPMENT Furniture & equipment

Less accumulated depreciation Property & equipment net

316,264 (250,242) 66,022

279,376 (229,799) 49,577

$ 2,861,983 $ 2,498,169

LIABILITIES & NET ASSETS

CURRENT LIABILITIES Accounts Payable $

Accrued expenses

Deferred revenue Total current liabilities

NET ASSETS Unrestricted

Temporarily restricted Total net assets

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36,979 $ 113,629 1,822,716

1,973,324 866,979 21,680 888,659 $ 2,861,983

2014 nadp annual report

5,989 109,114 1,619,279 1,734,382 748,157 15,630 763,787 $ 2,498,169

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NATIONAL ASSOCIATION OF DENTAL PLANS (A nonprofit organization) Statements of Activities

for the years ended - December 31, 2014 and 2013

2014 2013

UNRESTRICTED NET ASSETS

REVENUES

Membership dues $ 1,279,056 $ 1,185,447

Education & meetings 648,661 621,285

Research & information 54,676 57,479

Other income 13,564 12,609 Total unrestricted revenues 1,995,957

1,876,820

Net releases from restrictions satisfaction of program restrictions 316,717

292,676

Total unrestricted revenue & reclassifications 2,312,674 2,169,496

EXPENSES Member Services

Education & meetings Research & information Government relations General & administrative Total expenses Increase in unrestricted net assets

316,370 528,436 278,737 670,535 399,774 2,193,852 118,822

277,901 543,992 287,047 640,601 353,229 2,102,770 66,726

TEMPORARILY RESTRICTED NET ASSETS

CONTRIBUTIONS Political Action Committee

Government Relations

20,050

13,450

302,717

282,676

Net Assets Released from Restrictions

Political Action Committee

(14,000)

(10,000)

Government Relations

Increase in temporarily restricted net assets

Increase in net assets

124,872

70,176

Net Assets at beginning of year

763,787

693,611

$ 888,659

$ 763,787

Net Assets at end of year

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(302,717)

6,050

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(282,676) 3,450

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Leadership Excellence Gabryl Award

u u u u

Tireless pursuit of favorable interpretations of the Affordable Care Act pediatric dental requirement and his countless contributions to the National Association of Dental Plans advocacy efforts earned Jeff Album of Delta Dental of California the prestigious 2014 Gabryl Award, the association’s highest honor. Often referred to as the lifetime achievement award, the Gabryl Award recognizes long-term (six years or more) volunteer leadership in advancing NADP’s mission.

Don Mayes Leadership Award The Don Mayes Leadership Award recognizes volunteer leadership spanning at least three years. In 2014, NADP honored Rob Goren, Delta Dental of Missouri and Linda Moore, Blue Cross Blue Shield of North Carolina for strengthening NADP’s market representation. As Chair and Vice Chair of the Membership Committee, they added 6 million in enrollment from members they recruited, moving the association market share from the 80% range to greater than 90%. They also broadened the association’s industry perspective through recruitment of two unique and vital industry segments: Delta Dental and Blue Cross Blue Shield plans.

u u u

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2014 nadp annual report

u u u nadp.org

2014 Star Award Recipients

Y

The Star Awards are presented annually to volunteers who go the extra mile in service to the

association. In 2014 NADP presented the Star Award to the following individuals:

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Shari Derhammer Guardian Life Insurance Research Commission Star

Amy Marko Dedicated Dental STI Operations WorkGroup Star

Alissa Gavrilescu Solstice Benefits Communications Committee Star

James Mullen Delta Dental of California State Exchange Task Force Star

Lori Heverly Guardian Life Insurance Government Relations Commission Star

Linda Neyhard United Concordia STI Codes Workgroup Star

David Hill Assurant Employee Benefits Government Relations Commission Star

Sue Wright Lincoln Financial Group Membership Committee Star

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Phone: 972-458-6998 Fax: 972-458-2258 Email: info@nadp.org Web: nadp.org

NADP's office hours Monday - Friday 8:30 am - 5:30 pm Central Time

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Evelyn F. Ireland, CAE Executive Director 972-458-6998 x 101 eireland@nadp.org

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Timothy L. Brown Deputy Executive Director 972-458-6998 x 104 tbrown@nadp.org

Jerry Berggren Director of Research & Information 972-458-6998 x 113 jberggren@nadp.org

Rene Chapin Director of Membership & Communications 972-458-6998 x 110 rchapin@nadp.org

Kris Hathaway Director of Government Relations 972-458-6998 x 111 khathaway@nadp.org

Brian Flynn Dental Informatics Manager 972-458-6998 x 109 bflynn@nadp.org

Eme Augustini State Affairs Manager 972-458-6998 x 112 eaugustini@nadp.org

Jeremy May Education Manager 972-458-6998 x 123 jmay@nadp.org

Lauren Oakley Web Manager 972-458-6998 x 105 loakley@nadp.org

Shayne Leatherwood Office Administrator 972-458-6998 x 102 sleatherwood@nadp.org

Jackie Matthews Executive Assistant 972-458-6998 x 103 jmatthews@nadp.org

2014 nadp annual report

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>

imagine

Imagine a market where your concerns and challenges are addressed.

Imagine a business partner dedicated to the success of your company. Finally, imagine a community of colleagues who share expertise, knowledge, and ideas to propel your company and career to the next level.

There is no need to imagine.

The Solution is simple.

NADP is the representative and recognized resource of the dental benefits industry. NADP is the largest non-profit, national trade association focused exclusively on the entire dental benefits industry, i.e. dental HMOs, dental PPOs, discount dental plans and dental indemnity products.

NADP’s mission is to promote and advance the dental benefits industry to improve consumer access to affordable, quality dental care.

NADP members include national commercial carriers, regional and single state companies, as well as companies organized on a non-profit basis.

There has never been a

better time to be a

member National of the

Association of Dental Plans! for more infomration visit

nadp.org

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> nadp.org

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National Association of Dental Plans 12700 Park Central Drive Ste. 400 Dallas, TX 75251 (972) 458-6998 nadp.org

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2014 nadp annual report

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