SmileCare Dental Group v. Delta Dental Plan of California
Opinion
Opinion
Gadbois, J.
ORDER GRANTING DEFENDANT’S MOTION TO DISMISS
I. Background
Plaintiff SmileCare Dental Group (“Smile-Care”), and defendant Delta Dental Plan of California (“Delta Dental”) offer dental health care plans to employers, labor unions, and individuals. According to SmileCare’s complaint, Delta Dental sells plans to 60% of all persons with dental coverage, and has enrolled approximately 95% of California dentists as Delta Dental service providers. FAC. ¶¶ 5-6. Delta Dental directly reimburses dentists for services they provide to patients, but under most plans, pays only a portion of the dentist’s fee. The patient is responsible for the remainder, called a “co-payment.” By contract, Delta Dental dentists promise to collect the co-payments from the patients. FAC. ¶8.
Plaintiff SmileCare offers a supplemental dental plan called “SmileCare Coverage Plus.” SmileCare sells Coverage Plus to patients already covered by dental plans which provide less than 100% coverage, including those covered by Delta Dental’s primary plans. FAC. ¶ 9. Since Coverage Plus pays the patient’s co-payment, patients with both Coverage Plus and Delta Dental insurance have 100% coverage.