Benefits administrator blog from Delta Dental

Category: Delta Dental plans and features (Page 1 of 2)

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

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.

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.

New teledentistry options: Toothpic and Virtual Consult

Two new teledentistry options have come to Delta Dental PPO™ and Delta Dental Premier® plans to deliver more value to members. Say hello to Toothpic and Delta Dental – Virtual Consult.

Utilizing these options doesn’t require any changes to the way your employees use their plans or cost your organization extra. Instead, they’re a new way for your employees to use their existing plan benefits — remotely. These new tools are an ongoing covered benefit and have no additional administrative costs or access fees for your group or your employees.1 When your employees use either of these tools, they can rest easy knowing that they’ll be connected with a licensed Delta Dental dentist they can trust.

Toothpic

Toothpic is a secure HIPAA-compliant app that provides a photo-based virtual diagnostic assessment from anywhere you have a smart device and an internet connection. It’s perfect for those who want a dental checkup with a Delta Dental dentist without an appointment. Toothpic lets your employees:

  • Get evaluations on their own schedule by submitting pictures of their mouth, teeth and gums
  • Receive a personalized in-depth report from a Delta Dental dentist within 24 hours
  • Check in for diagnoses on areas of concern and get info about their next steps

Virtual Consult

Virtual Consult is a secure HIPAA-compliant video-based tool for having a virtual appointment with a dentist. It’s ideal for your employees who have urgent oral care needs, like pain or a cracked or chipped tooth, and want to speak directly with a Delta Dental dentist. With Virtual Consult, your employees can:

  • Schedule and have a video appointment with a Delta Dental dentist without leaving home
  • Have quick real-time consultations on urgent issues even if they don’t have a dentist they see regularly
  • Get an e‑prescription and aftercare instructions for pain or infection

Virtual dentistry allows your employees to check in on their oral health from the comfort of their own home. Whether they’re just looking for a quick check-in or have an urgent concern, these teledentistry options can help them meet their needs with all the ease telehealth offers.

1. Members who have 100% coverage for oral evaluations and who have not exceeded their frequency limitations for office visits or limited oral evaluations are eligible to use Toothpic and Virtual Consult. Using Toothpic to receive a diagnostic report or using Virtual Consult for a remote visit each count as one office visit/oral evaluation for the purpose of frequency limitations.

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.

When life happens, there’s Smile On

As a benefits administrator, you know that people’s life circumstances can change at the drop of a hat. Most people get their insurance coverage through work, but what happens when they retire, lose their job or take a break from work? That’s when the Smile On program is there for them.

Smile On is a program designed to help employees with group benefits transition to individual plans. With this program, your employees don’t have to worry about losing dental insurance when their employer-offered coverage ends.

Smile On helps your employees stay covered

Retiring, being in between jobs, or being a contractor or part-timer shouldn’t mean going without dental coverage. That’s why Delta Dental offers the Smile On program.

Smile On offers an easy way to connect your employees with existing individual plans. Smile On plans are new coverage and not a continuation of plans your employees may currently have, but they still provide the essential coverage that helps your employees stay healthy and save money on dental costs. They’ll enjoy the peace of mind knowing that what’s important is covered.

Best of all, getting a plan is something that employees can handle all on their own. They just need to visit the Smile On page, get a quote and choose from the plans available in their ZIP code.

Smile On is easy to promote

You won’t be going it alone when you present Smile On to your employees. There’s a flyer you can use help them understand all that the program offers.

Remember, when your employees need coverage the most, Smile On helps you meet their needs.

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