Benefits administrator blog from Delta Dental

Category: Delta Dental plans and features (Page 1 of 3)

Learn more about the dental plans and features that Delta Dental offers.

Keep your Veteran employees shining with Delta Dental

This Veterans Day, Delta Dental gives thanks to the men and women who have served our country. Every day of every year, we’re committed to providing pathways for oral health care and more for U.S. Veterans. 

On Veterans Day and throughout the year, you can use the following resources from Delta Dental to let your employees know about the options that are available for Veterans, military retirees and their families.

Meeting Veterans’ oral health care needs

Did you know that your Veteran employees may be eligible for additional coverage?

The Delta Dental Veterans Affairs Dental Insurance Program (VADIP) provides dental insurance to more than 70,000 Veterans and their family members through an individual enrollment PPO program sponsored by the U.S. Department of Veterans Affairs (VA). Through VADIP, Delta Dental provides members with reduced premiums, three plan options and access to a nationwide network of dentists. Eligible beneficiaries include any veteran enrolled in VA health care or any individual enrolled in the VA’s Civilian Health and Medical Program (CHAMPVA).

Veterans whose VA coverage doesn’t include dental insurance can choose to be covered through VADIP, and even those who are eligible for VA care for some of their dental needs can still choose a Delta Dental VADIP plan for added dental insurance.

Delta Dental also seeks to meet the oral health care needs of military retirees through the Federal Employee Dental and Vision Insurance Program (FEDVIP), a PPO program that serves both federal employees and uniformed services retirees. Through FEDVIP, Delta Dental offers a choice between two plans: The Standard Plan provides care at a low premium, while the High Plan offers greater coverage with an unlimited in-network annual maximum. With FEDVIP plans, as with all VADIP plans, 100% of preventive care is covered when the member visits an in-network dentist.

Through a recent partnership with TriWest, Delta Dental also helps provide access to care in 14 states for an estimated 1.3 million Veterans and their family members through the Veteran Affairs Community Care Network. Through the program, eligible participants can receive treatment from providers in their own communities when the VA can’t provide the care they need.

If your Veteran employees have both employer-sponsored coverage and a plan designed for Veterans, coordination of benefits is simple. They’ll need to ask their dental office to include information about both plans with their claims — Delta Dental will handle the rest.

Resources for your Veteran employees

This Veterans Day, keep your employees informed about the options available for Veterans, military retirees and their families:

  • Post a Delta Dental FEDVIP fact sheet on your website.
  • Share a flyer about VADIP.
  • Remind your employees of enrollment periods:
    • Eligible employees can choose to enroll in FEDVIP during Federal Benefits Open Season, a four-week period that occurs this year from November 8 to December 13 for coverage starting January 1, 2022.
    • Those eligible for VADIP can opt in at any time, with coverage beginning the first of the following month after enrollment.
  • Tell eligible employees about the advantages of dual coverage. For more information on coordinating Veterans benefits with employer-sponsored coverage, visit Delta Dental’s FEDVIP FAQ or the VA’s FAQ.

Delta Dental’s ongoing commitment to Veterans

Delta Dental provides almost $13 million annually in support of community health clinics, federally qualified health centers and nonprofit dental clinics, all of which help serve Veterans. In addition, the Delta Dental Community Care Foundation will give nearly $700,000 this year to support Veteran-serving organizations:

  • The American Red Cross— Armed Forces Emergency Services helps members of the military, Veterans and their families respond to the challenges of military service and civilian life afterwards.
  • The Dental Lifeline Network provides Veterans with free or discounted dental care.
  • The Joint Military Coalition, through a partnership with Delta Dental, was able to award 50 scholarships last year in the amount of $2,000 to Veterans and military members pursuing health and wellness training.

Delta Dental employees also participate in a number of volunteer and fundraising events throughout the year that support Veterans and active-duty service members:

  • Sneakers for Soldiers. Delta Dental employees run, bike and walk in an annual Veterans Day 5K to help send athletic shoes to men and women deployed in combat.
  • Carry the Load. Last Veterans Day, Marty Sheetz, Marine mom and Delta Dental Vice President of Customer Onboarding and Operations, helped organize two Carry the Load virtual 5ks with a total of 1,300 participants. The event encouraged participants to march or carry a symbolic load to represent sacrifices made by military, Veterans, first responders and their families.
  • National Disabled Veterans Winter Sports Clinic. Delta Dental helps sponsor this annual five-day sports retreat near Aspen during which Veterans with injuries or disabilities are encouraged to challenge perceived limitations.

Whether through dental insurance, through support from our foundation or through committed volunteers, Delta Dental is always seeking to provide support and care for U.S. Veterans.

Orthodontics are becoming a more important benefit for employees

Brace yourself — National Orthodontic Health Month is here! When it comes to choosing dental benefits to attract and maintain top-tier talent, orthodontic coverage is essential. Here’s a deeper dive into orthodontic coverage and the value it brings to you and your employees.

More people are interested in braces

Braces do more than give people a pretty smile. By ensuring proper alignment of the teeth, orthodontics can make it easier to bite, chew and speak. Misaligned teeth are also harder to clean and can wear in unusual ways. Minor untreated issues can lead to more serious problems further down the road, and that can mean increased utilization costs for your business. Far from being a luxury, orthodontic treatment can be essential to proper dental health.

When you imagine your average person with braces, you probably picture a teenager whose parents want them to have a beautiful smile. While most of the over 4 million people in the United States who are currently undergoing orthodontic treatment are teens, over 25% of current patients are adults, and these numbers are expected to grow. The number of adults seeing orthodontists is at an all-time high, according to the American Association of Orthodontists, and that means the pool of prospective ortho patients is wider than it’s ever been. Even childless adults may be interested in these benefits, such as the young professionals in the job market.

Employees expect to see dental insurance among their benefits, and orthodontic coverage can help your plans stand out from competitors. Fortunately, Delta Dental plans offer such coverage at affordable price points.

What kind of coverage does Delta Dental offer?

Without insurance, prospective orthodontic patients can expect to pay between $3,000 and 6,000 dollars depending on their age. Delta Dental plans can help cut these costs in half. That’s why Delta Dental’s been recognized as the best overall dental insurance for braces in 2021.

Orthodontic coverage is available under both Delta Dental PPO™ and DeltaCare® USA:

  • Delta Dental PPO plans vary by group and may include orthodontic coverage. You can choose to limit orthodontic coverage to children under 19 or cover orthodontics for both children and adults. Coverage is usually subject to a lifetime orthodontic maximum per person.
  • All DeltaCare USA plans cover orthodontics at set copayments, with no maximums or deductibles.

While specifics vary depending on your plan, coverage usually includes:

  • Pre-orthodontic treatment visits
  • Exam and start-up records
  • X‑rays
  • Orthodontist-recommended tooth extractions
  • Comprehensive orthodontic treatment
  • Post-treatment records
  • Orthodontic takeover for treatment that’s already in progress

Plans generally don’t cover the following:

  • Orthodontic treatment for children delivered in two phases
  • Appliances to correct harmful habits (like thumb-sucking)
  • Jaw surgery to facilitate orthodontic treatment
  • Treatment to prepare for other non-covered surgical procedures

Alternative appliances like Invisalign, mail-order appliances and teleorthodontistry generally aren’t, but Delta Dental usually still covers some of the orthodontic treatment costs, such as x‑rays and exams.

Want to help your employees understand their out-of-pocket costs? For PPO plans, encourage your employees to ask their orthodontist for a pre-treatment estimate. DeltaCare USA members can check their plan booklet for their copayments.

From children to adults, the interest in orthodontics is only growing, especially among adults. You won’t want to miss out on delivering benefits that employees love — and expect. Consider adding orthodontic coverage to your plan — or expanding the orthodontic coverage you currently offer.

With Delta Dental’s plans, your employees can find the orthodontic coverage they’re looking for at a price point they can afford, and that’s a great reason to smile.

Delta Dental gives access to healthy smiles in many languages

Language should never be a barrier when it comes to health care. If any of your employees have limited proficiency in English, direct them to Delta Dental’s Language Assistance Program (LAP). This service is free for members and perfect for employees who communicate in languages other than English to better understand their plans or even to communicate with their dentist.

The LAP offers a variety of language accessibility services, including:

  • The Delta Dental website in Spanish offers information on Delta Dental’s different plans, as well as articles jampacked with valuable wellness information.
  • Customer service is offered in 170 different languages. Simply call 866–530-9675 and request an interpreter.
  • Delta Dental’s online dentist directory is available in both Spanish and English and includes the languages spoken by dentists and staff members. This is a great tool for helping members find a dental office where their language is spoken.
  • In-person interpretation services are also available for dental visits. If a member cannot find a dentist who speaks their language, Delta Dental can arrange to have an interpreter present during their next appointment. In addition to non-English languages, American Sign Language interpretation can also be requested. All the member needs to do is contact Customer Service at least 72 hours in advance and make the request.
  • Document translation to any non-English language can be requested for any written materials, such as benefits information. Accessible formats like braille and audio files can also be requested.

If any of your employees are having trouble communicating with their dentist, call Delta Dental to arrange for a qualified interpreter to help via phone. 

Delta Dental telephone numbers for interpretive services: 

  • State Government Programs: 877–580-1042 
  • Delta Dental Premier®/Delta Dental PPO™: 888–335-8227 
  • DeltaCare® USA: 800–422-4234 
  • DeltaVision®: 888–963-6576 
  • TTY 711 

You can now pair VSP vision coverage with your Small Business Program plan

Insurance coverage can be complicated, but Delta Dental is making it simpler. You can now get Delta Dental’s Small Business Program (SBP) dental plans and VSP® vision plans together. That means industry-leading vision and dental coverage are now available conveniently paired together with a single itemized invoice.

These new vision plans feature comprehensive coverage on VSP’s nationwide network. They’re available in the same three-level structure as SBP dental plans (Deluxe, Advantage and Core), so you don’t have to worry about learning a new system and explaining it to your employees. Benefits vary by level, but every vision plan includes:

  • Coverage for an annual eye exam and lenses
  • A frame or contact lens allowance (contact lenses are available in place of lenses and frames)
  • Access to VSP’s nationwide network

When you pair VSP vision coverage with a Delta Dental SBP plan administered by Allied Administrators, you make billing simpler for you and getting care simpler for your employees. If you want to learn more or get a quote, visit our Sales Contact page. It’s easy to see that’s a win-win.

Vision coverage is provided by VSP.

©2021 Vision Service Plan. All rights reserved.

VSP is a registered trademark of Vision Service Plan.

SmileWay Wellness Benefits help employees stay healthy

More people are becoming aware of the way that health issues can manifest in the mouth and oral health issues can exacerbate other medical conditions. With serious issues like heart disease being responsible for so many deaths in the U.S., your employees may be interested in learning how good dental health can improve their overall health. If they have medical conditions that affect their oral health, SmileWay® Wellness Benefits may help meet their needs.

Who’s eligible for SmileWay Wellness Benefits?

Not everyone is eligible for SmileWay Wellness benefits. To claim these benefits, your employees must:

  • Have a Delta Dental PPO™ plan
  • Belong to a group that offers SmileWay Wellness Benefits
  • Have chosen to opt in to the program

If your employees have been diagnosed with any of the following, then they are eligible for expanded coverage:

  • Diabetes
  • Heart disease
  • HIV/AIDS
  • Rheumatoid arthritis
  • Stroke

What are the benefits?

If your plan includes SmileWay Wellness Benefits, then employees are eligible for these added benefits each calendar or contract year:

  • 100% coverage for one scaling and root planning procedure per quadrant (D4341 or D4342)
  • and 100% coverage for four of the following in any combination:
    • Prophylaxis (D1110 or D1120)
    • Periodontal maintenance procedure (D4910)
    • Scaling in the presence of moderate or severe gingival inflammation (D4346)

If your employees have medical issues that necessitate extra dental care, consider adding SmileWay Wellness Benefits to your coverage and letting them know. These benefits can help keep your employees both smiling and healthy, and healthy workers are a win-win for your company!

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.

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