The Umbrella PPO Network Cheat Sheet: Every Major Leasing Relationship in Dental

Most dental practices don't know who's actually repricing their claims.

They contract with Humana. They accept Principal. They see Ameritas on an EOB. And somewhere in the fine print of each participation agreement is a clause that allows those plans to lease your contracted rates to a third-party network — at a different fee schedule than what you agreed to.

That's the silent PPO problem. It's not illegal. It's barely disclosed. And it scales directly with your patient volume.

What is an umbrella PPO network?

An umbrella PPO network (also called a leased network or repricing network) is a third-party organization that brokers access to dental providers on behalf of multiple insurance plans. Instead of each insurance company building its own provider network from scratch, they lease access to an existing one.

The plan you contracted with hands your participation agreement — and your fee schedule — to a network aggregator. When a patient covered by any plan that leases that network comes in, your claim gets repriced at whatever rate that aggregator's contract allows.

You signed a contract with Humana. But Humana's contract lets Zelis access your rates. Zelis's rates may be lower. The patient's EOB shows Zelis as the processor. The write-off is larger than you expected. Most practices just post it.

The 6 major umbrella networks

There are dozens of repricing networks in the US, but six control the vast majority of volume in dental:

• Zelis (formerly Maverest/Stratose) — The largest dental repricing network. Routes claims for Humana, Principal, MetLife PDP Plus, select Cigna plans, and 750+ other payers.
• Careington International — Routes claims for select UHC dental, some Humana plans, select Aetna employer groups.
• DenteMax — Subsidiary of BCBS Michigan affiliate network. Routes claims for Ameritas, Mutual of Omaha, Lincoln Financial, select regional BCBS plans.
• Connection Dental / GEHA — Federal employee dental primary network. Routes GEHA, MODA Health, and FEHB plan participants.
• DHA (Dental Health Alliance) — Aetna-affiliated. Routes select Aetna DPPO plans, CVS/Aetna MA dental, some Cigna employer groups.
• Delta Dental Premier — The lower tier within Delta's own network. Premier rates are below PPO rates — knowing which tier applies on a given patient changes the write-off math significantly.

Quick reference: common plans and where they reprice

How to audit your own write-offs

You don't need a consultant to find leakage. Pull the last 90 days of EOBs for any plan marked with a ✓ "often repriced" above and do three things:

1. Check the processor name on the EOB. If it says Zelis, Careington, DenteMax, or Connection Dental — and that's not who you contracted with — you're being repriced through a leased network.
2. Compare the allowed amount to your contracted fee schedule. The difference is your leakage per claim. Multiply by volume to get your annual number.
3. Find the leasing clause in your participation agreement. It's usually called "network leasing," "third-party access," or "expanded network access." That clause is what's allowing this. Knowing it exists gives you something to negotiate against at renewal.

The full cheat sheet

We've mapped all six networks in detail — every major plan relationship, fee schedule impact notes, and a visual breakdown of how leasing works — in the PayorMap Pro resource center.

It's designed to be printable. A lot of teams pin it up in the billing office as a quick reference before posting write-offs.

PayorMap is a dental PPO intelligence platform that maps network routing, fee schedules, and leasing relationships so DSOs and group practices can see exactly where their revenue goes. Start a free trial →