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.

How COVID-19 is changing benefits in 2021

The global pandemic has had a profound impact on the way corporations attract, develop and maintain their human capital, and this includes changes to benefits packages. A June 2020 survey by Mercer found that some of the most common benefits changes that companies were considering in response to the pandemic included:

  • Expanding virtual health and telemedicine programs
  • Enhancing mental health support (including employee assistance programs)
  • Adding or expanding voluntary benefits

Have those predictions panned out? The International Foundation of Employee Benefit Plans (IFEBP) conducted a survey of U.S. employers to determine how the way businesses think about offering benefits has changed because of COVID-19. This study has found a move towards telemedicine, mental health benefits, flexibility around leave and greater consideration given to cost-saving measures. 

Fewer in-office visits means more telemedicine coverage

From visiting the dentist to an unexpected trip to the emergency room, in-office visits of all kinds are down from 2019 rates. That doesn’t mean that people are necessarily receiving less care, though. According to the IFEBP survey, nearly nine out of 10 employers reported seeing an increase in the number of telehealth claims filed in 2020. Dental offices are safe to visit, but for employees who are trying to socially distance (or simply have difficulty fitting a trip to the dentist into their schedule), Delta Dental offers multiple virtual dentistry solutions.

Stress and isolation lead to a greater emphasis on mental health benefits

Mental health claims saw a sharp rise in 2020. As employees cope with the stress and isolation that living with the realities of COVID-19 can cause, adding or enhancing access to mental health care is a cost-saving move. The effects of stress, depression and anxiety may not be as visible as with other issues, but they are no less real. They can lead to missed work and physical health issues, and so they’re equally important to cover with mental health benefits or employee assistance programs that offer support to employees.

More flexibility in leave is required as life throws curveballs at everyone

It’s important to be compassionate and flexible when it comes to your employees’ physical and emotional needs. Parents and other caregivers have been hit disproportionately hard by the pandemic and may need additional support as they try to juggle their work and home lives. Emergency leave for child or elder care, flexible use of paid and unpaid leave and offering carryover options for workers who can’t use their current vacation days are becoming more common.

Voluntary plans are becoming more popular to help keep costs low

Finally, consider that it may be in your organization’s best interests to change the kind of benefits offered. Voluntary plans are a great way to ensure that those who want dental coverage can keep it, even if cost-saving measures become necessary. The Smile On program is also available to provide dental coverage to those who are transitioning out of the workforce.

Communication is key

No matter how your benefits may change in response to the pandemic, being transparent and honest with your employees is essential. By alerting employees to benefits changes, you can ensure that they won’t be caught by an unpleasant surprise. Additionally, letting your employees know when new benefits are available and how to make the most of them can help keep them happier and healthier.

Effective discount: Understanding a plan’s true savings

When you consider a PPO dental plan, certainly one of the deciding factors is savings — during a dental visit, how much will this plan save my employees?

Traditionally, a good way to judge this has been to consider the plan’s PPO network discount, or the discount offered on dental services when visiting a dentist within the plan’s PPO network. After factoring in the fees, the greater the discount, the better the plan, right?

Not exactly. While PPO network discount is one chapter of savings, it’s not the whole story. A more accurate way to gauge a plan’s true savings is to consider the plan’s effective discount. The effective discount considers the average savings enrollees receive when visiting any dentist, either in network or out of network.

It’s here where Delta Dental offers a unique advantage: the Delta Dental PPO™ plan with the Delta Dental Premier® network.

With most PPO plans, the PPO network is absolute — you’re in or you’re out. And if you visit an out-of-network dentist, you’re responsible for the full cost of dental services provided by that dentist. The Premier network offers a secondary network that acts as a “safety net” if a PPO enrollee can’t find, or chooses not to visit, a dentist within the PPO network.

While the Premier network provides a smaller discount than the PPO network, the combined size of the two networks — more than 155,000 unique dentists as of 2020 — ensures that most people covered under a PPO plan can visit a Delta Dental dentist and save. This large network enables Delta Dental to deliver a national network utilization rate of 94%, compared to an average PPO utilization of 65% for competitor networks.

And it’s this safety net that often makes a Delta Dental PPO plan a better value than one from another company.

For example, let’s look at a theoretical example in which there are two group PPO plans with identical fees: one from Delta Dental and one from a carrier without a secondary network. In each scenario, 10 people are insured. Five visit PPO dentists and receive a discount, and five visit non-PPO dentists. The Delta Dental plan provides a 35% discount at PPO dentists. The other plan provides a 36% discount at PPO dentists.

Given the otherwise identical scenarios, it might at first seem that the plan with the higher PPO network discount offers the better value. However, in the Delta Dental plan, four people can visit a Premier dentist for a 19% discount. Because only one person visits a non–Delta Dental dentist, the group receives a total effective discount of 25%. Contrast this with the other plan. Because half receive no discount at all, the effective discount is only 18%.

It’s not surprising then that Delta Dental offers groups the best effective discount in the country, averaging 29.4% nationally in 2019, according to a July 2020 study by Dental Actuarial Analytics. This equals more than $8.2B in savings for enrollees annually when compared to dentists’ average charges for services.

So remember when considering a dental plan for employees, savings is more than PPO discounts. When you consider effective discount, you offer a complete story. With an ending your employees should like.

New videos help explain Delta Dental’s online tools and networks

With a new series of educational videos, it’s easy to help your employees understand their plans. Whether your organization offers Delta Dental PPO™, DeltaCare® USA or both, you’ll find useful resources to explain Delta Dental’s networks and online tools.

Get to know Delta Dental’s online tools

Encourage your employees to sign up for an online account. This video walks employees through the robust online tools Delta Dental offers, including plan details, claim history, personalized cost estimates, the online dentist directory and a wealth of wellness resources.

What if your group’s plan doesn’t include the Cost Estimator? No worries. This shorter version of the same video touches on the same helpful features, minus the personalized cost estimate.

Understand the Delta Dental networks

A PPO plan offers savings, quality assurance and simplicity. Through this video, your employees will learn the advantages of this plan and the steps for finding a PPO dentist online.

Want to expand your employees’ options with the Delta Dental Premier® network? This video introduces both the PPO and Premier networks and explain how to search for both in our dentist directory.

If you offer a DeltaCare USA plan, help your employees understand how this prepaid plan works and show them how to select a primary care dentist.

Ensure accessibility

These videos were designed with accessibility in mind. While the vibrant visuals support the narration, all key messages are conveyed in the audio, which can also be accessed through closed captioning.

Share the videos with your employees

To share these videos on your website or intranet, just click on the videos to navigate to YouTube. Below the video you wish to share, click on Share > Embed. Then copy and paste the code into your webpage or intranet site.

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.

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