Benefits administrator blog from Delta Dental

Category: Group dental benefits (Page 1 of 2)

Understand how dental coverage can help your organization. Take a peek at the ins and outs of group dental benefits.

Dental implants are coming to DeltaCare USA

A new kind of DeltaCare® USA plan is available to you in 2021. Effective January 1, 2021, DeltaCare USA i‑series plans will be available with comprehensive coverage for dental implants. Once i‑series plan rollouts are complete (there will be nine in total), they will be available in all 50 states and Washington, D.C.

These plans are designed to address the growing demand for more affordable access to dental implants. Coverage for dental implants is a valuable benefit that employees ask for, so offering an i‑series plan makes dental insurance a more compelling choice for more employees. You’ll be able to offer a plan that fits more budgets than ever before but still offers cost savings, more choices in treatment options and coverage for procedures like teeth whitening.

These new plans will expand the coverage available to employees looking for more affordable dental insurance. For more information, please contact your account manager.

The cost correlation: Dental benefits may lower businesses’ overall health spend

4‑minute read

It’s common knowledge that oral health is linked to overall well-being. What might surprise you, however, is the significant impact your employees’ oral health status can have on your business’s total health care budget. In fact, of the top 10 health conditions costing employers the most, five are linked to oral health.*

#1 Diabetes
Topping the list of costliest employer conditions is diabetes, affecting nearly one in 10 Americans. Not only do diabetics face a higher than normal risk for developing oral health problems like periodontal disease and oral infections, but these problems may be more severe for a diabetic person. It’s not all bad news though. It’s been suggested that treating gum disease can help control blood sugar in diabetic patients, which may slow disease progression. And, receiving routine dentist cleanings and practicing healthy oral hygiene habits may help to lower HbA1c levels (average blood glucose over time).

#2 Cancer
Oral cancer is likely not the first cancer that comes to mind for most of us. Yet, head and neck cancers (85% of which are oral) account for approximately $3.2 billion in treatment costs each year.

Oftentimes, the early symptoms of oral cancers go unnoticed by patients, making them particularly dangerous. That’s why regular dental exams are so important. Dentists and dental hygienists may be able to identify the signs and symptoms of oral cancers when they’re still in the early or even pre-cancerous stages.

#5 Heart disease 

The dental industry has been aware of the correlation between heart disease and oral health for years, and supporting evidence continues to emerge. While we still can’t say the relationship between oral health and heart health is causal, new research suggests that poor dental health, including gum disease and infrequent toothbrushing, may be a risk factor for heart disease.

#6 Hypertension
Recently, an association between hypertension and dental health has also been found — specifically blood pressure control. A new study showed that those with gum disease were less likely to respond to hypertension medications than those with good oral health. The authors of this study go on to say that “those with high blood pressure might benefit from regular dental care”.

#10 High-risk pregnancy
Compared to the average employer medical costs for a healthy, full-term baby, the costs for premature and/or low-birth weight babies is nearly 12 times as much. While the relationship between periodontal disease and adverse pregnancy outcomes is still being explored, we do know that a mother’s health can impact her baby — and oral health is no exception. Research suggests that expectant mothers with poor oral health may face higher risks of pre-term delivery and of passing disease-causing bacteria to their child. This makes it even more important for expectant mothers to receive regular dental exams during pregnancy. The dentist can evaluate the individual needs of the mother and may even recommend an additional cleaning.

How can dental benefits help?

Regular dental care can help manage certain health conditions and even detect some early, which can help prevent costly medical expenses in the future.

However, your dental benefits may be able to do more than cover routine dental care to improve wellness. Ask these questions about your dental benefits to find out how they can boost overall health and your business’s bottom line:

  • Is there extra support for those with chronic conditions such as diabetes or heart disease? Providing additional coverage to enrollees with certain medical conditions may prevent or halt the progression of disease, which can help you manage dental and medical expenses down the road.
  • How can I track employees’ oral health status? Do I receive useful reports? Regular reporting on your enrollees’ oral health habits can highlight where your group is doing well and help identify areas where enrollees can improve oral health, and in turn, improve overall health.
  • How is oral health supported during pregnancy? Are additional cleanings covered? An extra cleaning during pregnancy can lead to healthier babies and may lower certain pregnancy risks associated with oral bacteria.
  • Are oral health and wellness resources readily available? Your enrollees may not even be aware of the impact oral health can have on their overall health. Carriers who provide valuable wellness resources can help encourage enrollees to be active participants in their oral health.

 

For more news and dental insights for benefits administrators, human resources professionals and businesses, subscribe to Word of Mouth.

Are you a broker, agent or consultant? Subscribe to Insider Update, our newsletter for benefits producers.

 

*The oral health information in this article is not intended to be used as medical advice. Patients should always consult a licensed dentist or other qualified health care professional for any questions concerning oral health.

Tackling orthodontics

With football season just around the corner, it seems fitting to tackle a popular, yet often misunderstood topic — orthodontics. If you’re offering your employees orthodontic coverage, make sure you’re up to speed on your dental benefits game.

If you don’t already offer orthodontic benefits, you might consider coverage at renewal, as it can be an attractive benefit if you’re trying to build or retain your workforce. A recent study shows that 88% of employees take “better health, dental and vision insurance” into consideration when choosing a job.

The Xs and Os

Generally, here’s what our plans cover*:

  • Pre-orthodontic treatment visit
  • Pre- and post-treatment records
  • Extractions for orthodontics
  • Orthodontic treatment
  • Retention

The MVP

Our copay orthodontics game is strong! Compared to typical copay products (similar to DHMOs), DeltaCare® USA is leading the league, with features like:

  • A variety of treatment levels — interceptive orthodontics for children, limited orthodontics for children and adults, and comprehensive orthodontics for children and adults*
  • A unique orthodontic takeover provision that allows enrollees to continue active treatment with their current orthodontist — even if the provider is not in our DeltaCare USA network
  • Extractions for orthodontic treatment that could save enrollees hundreds of dollars out-of-pocket

If you currently offer orthodontic coverage, review the playbooks for Delta Dental PPOTM and DeltaCare USA plans and pass them on to your employees. For specifics, you can review your group contract and enrollees should log in to Online Services (or review their plan booklet) to confirm coverage.

 For more news and dental insights for benefits administrators, human resources professionals and businesses, subscribe to Word of Mouth.

Are you a broker, agent or consultant? Subscribe to Insider Update, our newsletter for benefits producers.

 

* Your benefits may differ from the general information provided here. Review your group contract for specific details regarding coverage under your plan.

Everyone wants (but doesn’t use) this employer-sponsored benefit

2‑minute read

When people search for jobs on LinkedIn, Glassdoor, Indeed, etc., they surely expect to find a section of each job ad that includes a brief description of benefits and perks. Some company benefits are traditional while others get creative. And a few things are usually constant – paid time off, 401(k) options and health insurance – both medical and dental.

It’s no industry secret that enrollees expect dental coverage in their benefits package. In fact, 88% of job seekers say they would give better benefits some, or heavy consideration when choosing between employers, even if the pay were lower.

So we know that people want — and even expect — dental coverage from their employers and organizations; however, the fascinating thing is that enrollees often don’t use this must-have benefit.

Using claims data* from our enterprise, we found that only 37.2% of enrollees received the recommended two annual cleanings in 2017. And 23.9% of enrollees received only one cleaning. If you’re a current Delta Dental client, or work in the benefits industry in general, does it surprise you that nearly 40% of enrollees didn’t visit the dentist?

Since routine preventive dental care can detect health problems early, and help to prevent more costly medical expenses down the road, it’s concerning that more people aren’t seeking preventive care more often. To curb this trend, consider encouraging enrollees to visit the dentist for their recommended diagnostic and preventive care.

Share the wellness benefits of exams and cleanings with them. We recommend content from the preventive care section of our SmileWay® Oral Health library.

Do you know people who are anxious about visiting the dentist? Check out our tips for easing these fears. As a bonus, watch the magic of dentistry at work — proof that visiting the dentist can even be fun. 

Want more benefits solutions, industry news or HR tips and tricks? Subscribe to Word of Mouth.

If you’re a broker, consultant, or other benefits producer, subscribe to Insider Update.

 

* Data is based on submitted claims for commercial Delta Dental PPO enrollees, excluding state or federal exchange enrollment. Cleanings are based on claims including the following procedure codes: D1110, D1120 and D4910.

See how your benefits know-how scored: Get the answers to our scavenger hunt

Last week we challenged you to test your knowledge of our benefits administrator website with a fun online scavenger hunt. Although we hope you had some fun, our main goal was to make sure you’re getting the information and tools you need to support your enrollees and manage your dental benefits effectively. Let’s see how you did!

Wait — no cheating! If you haven’t already completed our scavenger hunt, give it a try before reading the answers below.

Q: Which two types of dental plans do the benefits administrator (BA) pages help you manage?

(a) Tri-Delta DentalTM and Copay® USA

(b) Delta Dental PPOTM and DeltaCare® USA

© McDelta® USA and Delta DentalTM Care

(d) DentalCareTM  PPO and SmileWay® USA

A: The correct answer is (b) Delta Dental PPOTM and DeltaCare® USA

From the BA site, you can find detailed information on how Delta Dental PPO and DeltaCare USA work, learn about web features for enrollees and get the answers to the most commonly asked enrollee questions.


Q: How do your enrollees get a mobile ID card?

A: If you got the last question right, you had a good clue on where to find this answer. (Hint: Check the FAQ pages for Delta Dental PPO and DeltaCare USA.)

So here’s the deal — your enrollees don’t actually need an ID card to receive treatment. They can simply give the dentist their name, date of birth and social security number or enrollee ID to verify coverage. But this isn’t a trick question. If enrollees prefer to have a card, they can display mobile ID cards or print them by creating a free Online Services account.

 

Q: Which of the following can you do with our Find a Dentist Tool? (You can pick more than one)

(a) See if a particular dentist is in our networks.

(b) Search for providers by location or specialty.

© Find directions to the center of the earth.

(d) Explore provider Yelp reviews.

A: Your enrollees can do all of the above with our Find a Dentist Tool — except find directions to the center of the earth. Although, you can get maps to providers’ offices.

 

Q: Do your enrollees need to file a claim when they visit a Delta Dental network dentist?

A: The short answer to this is no, not in most cases. Here’s the long answer:

For Delta Dental PPO enrollees, Delta Dental dentists will submit claims for your enrollees. However, if an enrollee chooses to visit a non-Delta Dental dentist, he or she may need to file the claim themselves.

With DeltaCare USA, there are no claims forms for enrollees to complete when they visit their selected dentist for routine care. However, if enrollees receive specialty care from a dentist other than their primary care dentist, or are traveling and need emergency care, they may need to submit a claim.

You can find more claims information and claims resources for enrollees in the manage your plan section of the BA site.

 

Q: Where can you find our online library of enrollee oral health articles, videos, assessments and more? (Bonus points if you know the name of our wellness program)

A: On the SmileWay® site — SmileWay also happens to be the name of our wellness program. If you haven’t already, be sure to check it out, and encourage your enrollees to do the same. The site offers all kinds of helpful information about healthy habits, conditions, treatments and more.

 

Thanks for participating in the scavenger hunt!

For more news and dental insights for benefits administrators, human resources professionals and businesses, subscribe to Word of Mouth.

Are you a broker, agent or consultant? Subscribe to Insider Update, our newsletter for benefits producers.

How to give your dentist network a checkup

2‑minute read

You may have read in last month’s network numbers article that network size matters. However, size is just one piece of the puzzle when it comes to determining network value. It’s also important to know how dentists are recruited and trained — and to take a look at the entire experience enrollees have when they visit a dentist’s office. Here are some things to consider when evaluating a dentist network.

The right dentists in the right places

How valuable is a large dentist network if there aren’t any providers near where your enrollees live and work? Not very. Building a strong network is more than a numbers game — it’s about ensuring that your enrollees have easy access to great providers, both general dentists and specialists.

Look for a carrier with a strong recruitment presence near your group. Even if there isn’t a strong dentist network there now, carriers with a solid recruitment team can work with you to build the dentist network your group deserves. Are there particular dentists your enrollees want to visit, but they’re not in network? Some carriers will actively recruit the specific dentists your group wants.

Check out Delta Dental’s dentists in your area, now with Yelp reviews!

Face-to-face training and provider management

While dentist recruitment is important, it’s crucial to work with a carrier who ensures that the quality of care your enrollees receive remains top notch. One good way to gauge this is to find out if your carrier has staff dedicated to working in the field, or if network management is handled remotely. With boots on the ground, network providers can receive thorough in-person training. Plus, your carrier can easily stop by providers’ offices to get a firsthand experience of the level of care provided.

It’s also wise to ask your current or future carrier how it defines a quality dental experience.

  • Are only dentists evaluated, or does the carrier also assess the performance of dental hygienists and assistants?
  • Is the appearance and cleanliness of the dental office taken into consideration?
  • Does the carrier prioritize a smooth appointment check in and payment process for enrollees?

Want to learn how our networks can provide a seamless solution for your group? Talk to your Delta Dental sales rep today! And stay tuned for the next part of this network series, which will highlight the impact leased networks can have on your group.


For more news and dental insights, subscribe to our email list for benefits administrators, human resources professionals and businesses.

Are you a broker, agent or consultant? Subscribe to Insider Update, our newsletter for benefits producers.

« Older posts

© 2021 Word of Mouth

Theme by Anders NorenUp ↑