Willamette Dental Group Market Analysis: Market Share and Coverage by State

Payer Overview

Willamette Dental Group operates as a regional dental payer with a concentrated presence in the Pacific Northwest, ranking as the #182 US A&H payer by premium. Its reported US premium is $153.03M, representing a 0.01% US market share and a footprint across 3 states. The organization serves an estimated 22.8K members and operates through 3 affiliated subsidiaries, which supports its market activities across Idaho, Oregon, and Washington.

Willamette Dental Group does not hold a #1 position in any single state. The payer's US premium reflects its focused strategy within a limited number of states rather than a broad national footprint. This concentrated profile shapes contracting leverage and network strategy, especially for multi-state provider groups operating in the Pacific Northwest.

Premium by Scope

Willamette Dental Group's premium is exclusively within the US States & DC scope based on the provided data; there is no reported premium in US territories or foreign jurisdictions. This concentration implies that providers negotiating with this payer will be addressing a payer whose commercial risk and contracting exposure are localized to the continental US footprint reported here. For multi-state provider groups, the payer's concentrated premium suggests negotiation strategies can be tailored to regional market dynamics rather than a broad national approach.

National Market Footprint

Willamette Dental Group shows heavy concentration in the Pacific Northwest, with $153.03M of premium written across three states and an estimated 22.8K members. The bulk of premium is in Oregon and Washington (each roughly $69M), indicating regional scale that can influence reimbursement levels and network design locally. For national payers and provider groups, this concentration means negotiating leverage and utilization patterns will reflect Pacific Northwest market dynamics rather than national averages.

State-by-State Market Position

Willamette Dental Group's strongest presence is in the West region, specifically the Pacific Northwest where Oregon and Washington together account for the majority of premium. Idaho contributes a smaller but meaningful share. There is no material footprint reported in the Northeast, Midwest, Southeast, or Southwest regions, so multi-region provider groups should view this payer as a regionally concentrated counterparty.

Because premium and membership are concentrated in contiguous states (OR, WA, ID), multi-state provider groups operating across these borders can pursue coordinated contracting strategies to capture regional scale. The payer's concentrated premium profile means provider negotiations will likely be most impactful when targeted at the Oregon and Washington markets where premium levels are roughly $69M per state.

The Affordable Care Act (ACA) established federally-facilitated health insurance marketplaces ("exchanges") where individuals and small businesses can shop for and enroll in health plans, often with income-based subsidies. Issuers that participate in these marketplaces are required to report enrollment, claims, and denial data to CMS (Centers for Medicare & Medicaid Services) each year.

The sections below cover this payer's ACA marketplace-specific footprint — enrollment, plan portfolio, and claims/denial-rate data. This is a narrower, separate population from the NAIC-based commercial data shown earlier on this page (total premium, market share, and membership across all lines of business): ACA marketplace enrollment is typically a small fraction of a payer's total commercial book, and the two datasets should not be treated as equivalent. CMS claims-transparency reporting has also been inconsistent industry-wide since 2020 — many issuers have little or no data for 2021 onward, so a single reporting year is common and does not necessarily indicate anything about the payer's current ACA presence.

Estimated Member Demographics

Nationally, the largest age bands are 35–44 (3,516 members), 6–18 (3,475 members), and 45–54 (3,116 members). The distribution is relatively balanced, with substantial representation in both pediatric and adult populations. The senior bands (65–74 and 75+) are smaller but still notable, indicating a moderate presence of older adults.

State-level analysis shows Washington has the largest member counts across all age bands, followed by Oregon and Idaho. No state skews dramatically older or younger, but Idaho has slightly fewer seniors and children compared to Oregon and Washington. Overall, the member profile is diverse, requiring providers to address a wide range of dental needs.

Estimated Members by State

WILLAMETTE DENTAL GRP's estimated member distribution is concentrated in three states: Washington (11,669 members), Oregon (7,980 members), and Idaho (). Washington leads in total members, reflecting both a higher premium volume and a substantial market share. Oregon follows closely, while Idaho, despite a lower premium and market share, still maintains a significant member base.