Benefits administrator blog from Delta Dental

Tag: dental insurance (Page 1 of 6)

Thanks for brightening our year

Wishing you and your enrollees your healthiest, happiest holiday season yet.

While your enrollees’ smiles are our top priority, it’s your support that keeps us smiling in return. We’re so grateful for clients like you who make our entire year merry and bright!

We hope you’ve enjoyed reading Word of Mouth in 2018, and we can’t wait to bring you even more engaging content next year. Remember, this blog is for you – so we’d love your suggestions on topics you’d like to hear more about. And if you’re not already, be sure to subscribe to Word of Mouth so you never miss out on helpful articles, tips and industry news.

Cheers to the New Year! We’re looking forward to serving you in 2019.

Check enrollee notices off your year-end to-do list

1-minute read

With the holiday season in full swing, sometimes our daily to-do lists seem never-ending. That’s why we’re helping you cross one thing off your list: Educating new enrollees — and reminding current enrollees — about their rights.

Federal and state laws require groups to notify enrollees about enrollee rights and privacy practices.1 The good news is, we’ve made it easy for you to share this information.

You can learn more about the notices on our administrator web pages. Enrollees can also view and download each notice on our website. Additionally, during open enrollment we provide groups with an enrollee flyer summarizing the notices.

Please share the notices with current enrollees annually and with all new enrollees within 30 days of eligibility.

Not sure how to share? Here are some tips:

  • Post the notices on your company Intranet
  • Email employees a link to the notices
  • Place copies of the notices in common areas, or in the HR area
  • Include copies of the notices in your next company mailing

If you or enrollees have any questions about the notices, you can call 866-530-9675.

Now, take a deep breath and get back to the rest of your to-do list.

For more tips like this for benefits administrators, human resources professionals and businesses, subscribe to Word of Mouth.

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1 Self-funded groups are not required to share Delta Dental’s enrollee notices and may opt to use their own notices; however, these notices cannot be in conflict with Delta Dental’s practices. If you have questions about your notices, 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.

What to ask about leased dentist networks

3-minute read

Cars, houses, clothing, even dogs — the list of items Americans lease today continues to grow. The world of dental benefits is no exception to the trend. Oftentimes, to expand network size, a dental carrier will lease a dentist network from a third party (either another carrier or a company that aggregates dental networks). While the potential for more dentist access is tempting, it’s important to know if a leased network can truly deliver more value to your group.

If your carrier leases its dentist networks, or you’re considering a carrier who does, ask these questions to see how it could impact your group.

 

  1. Who holds the contract with the leased network dentist? The primary carrier or a third party?

Why it matters: In many cases, when a carrier leases a dentist network, there is no direct contract or relationship with the leased dentists. This may create difficulties in resolving disputes through a third party, which could mean unhappy enrollees. It may also cause confusion about which claims guidelines and processing policies apply. This could leave enrollees waiting longer for a claim to process or even cause an enrollee to be billed incorrectly.

  1. Are leased network dentists held to the same credentialing and quality standards as non-leased dentists? Are they continually monitored by the primary carrier?

Why it matters: When portions of a dentist network are leased, there’s a possibility that their equipment, office cleanliness, treatment plans, safety measures and/or patient history have not been vetted as thoroughly as a carrier’s direct-contracted dentists. Furthermore, if the primary carrier is not involved in monitoring the leased network dentists, there may be no guarantee that these dentists are re-credentialed every three years or that they are credentialed to National Committee for Quality Assurance (NCQA) criteria.

  1. How much of a carrier’s dentist network is leased?

Why it matters: Dentist turnover might be higher if your carrier leases dentists. Why? Because a leased dentist’s network agreement could end before your benefits contract. This means, if a large part of a carrier’s dentist network is leased, there could be a greater chance your enrollees will find their dentist is suddenly no longer in network.

  1. Which fee schedule takes precedence when an enrollee visits a leased network dentist?

Why it matters: When a carrier leases a dental network from multiple companies or carriers, the same dentist could end up in more than one leased portion of the network. If this is the case, your group may end up with multiple fee schedules, which is known as stacking. This could cause inconsistent costs for your group if different fee schedules are applied across the network. Dentists may also be confused about how to bill your enrollee, which could potentially increase claims costs depending on which fee schedule they apply.

  1. How does the carrier ensure the accuracy of its leased dentist directory?

Why it matters: If a carrier does not hold a direct contract with its leased network dentists, it may be hard to ensure the accuracy of the dentist directory. This could create an unpleasant surprise for an enrollee if they’re billed for an out-of-network visit when they thought the dentist was in network. It could also lead to overstatement of network size.

  1. How much is the network access fee when an enrollee visits a leased network dentist?

Why it matters: A bigger network does not always mean bigger savings for your group. If a carrier leases dentist networks to increase their network numbers, you need to consider how much you’re being charged for access to the additional dentists. These fees may differ between portions of the network.

 

For more helpful tips about dentist networks, be sure to check out our blog articles on network quality and network size.

 

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.

4 ways to create a motivating workspace

2-minute read

Earlier this year, we shared how celebrating your employees can boost happiness and productivity. While showing appreciation for your employees is key, it’s not the only way to inspire your workforce. Designing the right work environment — from paint colors to plants — can also help motivate your employees. Check out our tips below to learn how the right office décor can uplift and encourage your team.

1. Don’t fear color. What color are the walls in your workplace? Are you surrounded by neutral tones or bold color? Research suggests that certain colors can affect a person’s productivity. If you want to spark some creativity in the office, try incorporating the color purple. If a laid-back vibe is what you want to evoke, try adding more blue and green to your surroundings. If you don’t want to saturate your entire workplace in color, consider painting a couple rooms to match the energy you’re after.1

2. Bring the outside in. You know how we just said green is a calming color? This is great news if your workplace has a view — nature is full of it! Try arranging your employees’ desks in a way that maximizes their view of the outdoors. What if your windows look out to a concrete jungle? Create your own lush landscape by decorating the office with plants and hanging artwork inspired by nature.

 3. Let there be (sun)light. While we all know too much sunlight can be harmful, sunlight in moderation can have mood-lifting benefits and may even help your employees stay focused.

“Exposure to sunlight is thought to increase the brain’s release of a hormone called serotonin. Serotonin is associated with boosting mood and helping a person feel calm and focused.” – Healthline Media2  

Keep the blinds open to let as much natural light in as possible. If your workplace lacks natural light, resist the urge to crank up the overhead lights, which can be a nightmare for migraine sufferers. Instead, try providing individual desk lamps so your employees can adjust lighting to meet their own preferences.

4. Live your brand. A great way to get your employees excited about your business is to put it right in front of them. Why not display your mission statement on the wall? What about painting accent walls or providing office supplies in your brand colors? By immersing your employees in your brand, you’re helping them become invested in the business, its goals and its success.

 

Want more tips like these? Subscribe to Word of Mouth, our newsletter for benefits administrators, human resources professionals and businesses.

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

 

1 http://www.arttherapyblog.com/online/color-psychology-psychologica-effects-of-colors/#.W4Qt5cJry01

2 https://www.healthline.com/health/depression/benefits-sunlight

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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