Benefits administrator blog from Delta Dental

Tag: preventive care (Page 1 of 2)

The D&P Maximum Waiver® helps employees save money and stay healthy

When it comes to using their benefits, it’s important for your employees to stay on top of their diagnostic and preventive care. By getting regular cleanings and exams, they can catch minor issues while they’re still easily treatable and prevent major issues from developing.

Sometimes employees may choose not to use their diagnostic and preventive benefits in an attempt to preserve their full annual maximum in case they need major services later in the year. Delta Dental’s D&P Maximum Waiver® option helps prevent this problem. By making it so diagnostic and preventive services don’t contribute to employees’ annual maximums, this feature helps employees make the most of their benefits, stay on top of their oral health and avoid more costly procedures. It also helps employees get more care each year without having to raise their annual maximum. Together, means less absenteeism and more savings for you.

What is the D&P Maximum Waiver?

The D&P Maximum Waiver is an optional feature that can be added to your Delta Dental PPO™ group plan. With this option, diagnostic and preventive services won’t count against the annual maximum. The D&P Maximum Waiver is available on members’ effective date and is simple to use, with no qualifying events or dollar amounts to track.

Common diagnostic and preventive services include:

  • X‑rays
  • Cleanings
  • Exams

How does the D&P Maximum Waiver help my employees and my company?

By ensuring that D&P procedures don’t count against their annual maximums, the D&P Maximum Waiver leaves more maximum dollars available to cover costly, extensive procedures employees might need, like fillings, gum disease treatment, root canals and crowns.

Here’s an example comparing the annual maximum dollars available for members with and without the D&P Maximum Waiver.

Routine dental exams, cleanings and x‑rays cost: $350Employee annual maximum: $1,000Employee’s plan pays: $350Employee pays out of pocket: $0Employee’s remaining annual maximum without D&P waiver:
$650
Routine dental exams, cleanings and x‑rays cost: $350Employee annual maximum: $1,000Employee’s plan pays: $350Employee pays out of pocket: $0Employee’s remaining annual maximum with D&P waiver:
$1,000
With the D&P Maximum Waiver, employees have more of their annual maximum left after getting diagnostic and preventive care.

To help your company’s bottom line, you can promote in-network utilization by setting up your D&P Maximum Waiver to only apply at Delta Dental PPO dentists. Adding the D&P Maximum Waiver option to your coverage also helps you save money by letting your employees’ dollars go farther without having to pay more for a higher annual maximum.

The D&P Maximum Waiver option is a great way to encourage your employees to make the most of their diagnostic and preventive coverage — and for your company to avoid lost productivity from dental issues. Reach out to your Delta Dental Account Manager today to learn more about adding this feature to your plan.

Get ready to brush even smarter

Going to the dentist for regular checkups is important for maintaining oral health, but what can people do at home to keep a bright and healthy smile? BrushSmart is Delta Dental’s free oral wellness program designed to help members power up their at-home oral care. Members who sign up get exclusive discounts and offers from trusted brands that specialize in dental products. This spring, BrushSmart is adding more partners and more discounts.

  • Oral‑B
  • Philips Sonicare
  • quip

Joining BrushSmart is great for your employees with Delta Dental plans. The engagement and rewards the program offers can help drive better oral health behavior and the focus on at-home care may help employees achieve better health outcomes. Let your employees know they can sign up online and take control of their oral health.

4 oral health problems teens face and how you can help

When you’re building your benefits package, are you thinking about teenagers? You may not have benefits-eligible teenage employees, but it’s likely your benefits package will be covering teenagers as dependents. Here are some common dental concerns that teenagers face and how you can develop a better benefits package to help your employees’ children.

1. Cavities

With teens’ love of snacking and their inconsistent brushing habits, it should be no surprise that dental decay is the most common chronic disease in young people. There are some easy ways to stop cavities before they start. Sealants are thin coatings painted on the chewing surfaces of teeth that can prevent cavities for years, which means that sealants applied during childhood can help during the teen years.

2. Misaligned teeth

Permanent teeth replace baby teeth in older children, and the jawbones can continue to grow until the end of puberty. A misalignment of the teeth and jaws may get better ― or worse ― by the time the jawbones have stopped growing.

Without coverage, prospective orthodontic patients can expect to pay between $3,000 and $6,000 depending on their age. Delta Dental plans can help cut these costs in half. Orthodontic coverage is available under all DeltaCare USA group plans and can be optionally included in any Delta Dental PPO plan.

3. Impacted wisdom teeth

Wisdom teeth are the last teeth to develop and erupt into the mouth, usually in the late teens. Since the jaw is still growing, wisdom teeth are sometimes impacted, meaning they don’t have enough room to emerge or develop normally. Almost 5 million people get wisdom teeth removed every year in the United States.

Wisdom teeth extraction can be expensive. Consider having your plan cover a higher percentage of the cost of wisdom teeth extractions. If that’s not viable for your plan, a lower deductible can help families as well by letting them pay less out of pocket before they reach their deductible.

4. Eating disorders

About 9% of Americans will develop an eating disorder at some point in their life, often in their teenage years. Eating disorders are life-threatening conditions that can have serious consequences for oral health and overall health. They can cause nutritional deficiencies that effect the mouth, as well as sensitive teeth, frequent cavities and dry mouth as a result of purging.

Dentists can be a great ally in the fight against the effects of eating disorders like bulimia (PDF) by identifying signs of the disorder, like eroded enamel and damaged gums, and offering sealants and fluoride treatments. These treatments can help reduce the damage that stomach acid causes when someone vomits. Most plans cover sealants and fluoride treatments until patients turn 15. If you’re also handling your clients’ health care package, you may also consider covering mental health treatment that can help to treat the illness altogether.

What else can you do to support teens’ dental health?

While these problems aren’t unique to adolescents, it’s still a good idea to have these in mind when considering your company’s dental benefits. If you’re in a position to do so, consider sharing information that highlights plan features like teledentistry, which could be helpful for busy teens and their parents. You could also explore Delta Dental’s wellness resources and share a selection of helpful articles and flyers in an email or on an internal site.

Remember to be consistent! When communicating helpful information to your employees, using multiple channels can be confusing and difficult to keep track of. Find a simple routine for sharing, like posting information on an internal webpage with monthly or quarterly email notifications, so that your employees always know where to look.

Sealants: A great value for your employees

Children’s Dental Health Month in February serves as an annual reminder of how crucial it is to start young people early on the right path for a lifetime of oral health. Your employees naturally want what’s best for their kids, so a simple benefit like sealants that help protect children’s teeth can be an important part of their insurance plans. Here’s a closer look at sealants and the types of coverage Delta Dental offers.

What are sealants?

Sealants are plastic coverings applied to the deep crevices of teeth to seal them off from decay. Think of them like raincoats for the teeth. Sealants are most often applied to permanent back teeth because they have the deepest grooves and are at the highest risk of decay.

How effective are sealants?

Sealants provide protection against tooth decay, preventing 80% of cavities for two years and continuing to protect against 50% of cavities for up to four years. Children without sealants have almost three times more first molar cavities than children with sealants.

Who needs sealants?

Children and teenagers ages six to 15 are the best candidates for sealants. Sealants can be especially beneficial for kids who have a history of cavities or are otherwise at high risk for dental problems (such as from secondhand smoke or from medications that cause dry mouth).

Why is sealant coverage an important benefit?

Sealants aren’t just effective; they’re also cost-effective. Sealants prevent tooth decay and can spare your employees’ families the hassle, discomfort and expense of cavities. And unlike treatment for cavities, sealant application is a simple, one-time, painless procedure. Access to sealants through dental coverage can provide your employees’ children with a health advantage they’ll value for a lifetime.

Delta Dental offers sealant coverage for groups and individuals

Most Delta Dental plans cover dental sealants, so your employees with covered family members can often get their kids’ protective sealants at little or no out-of-pocket cost. Sealants are a standard benefit in group Delta Dental PPO™ plans. Coverage for sealants can vary by policy. All standard DeltaCare® USA plans cover sealants.

Plans that include sealants generally limit the benefit to permanent first and second molars subject to age limitations by contract. Under some Delta Dental PPO plans, there is a maximum allowance payable per tooth, and the patient is responsible for the remainder of the allowed fee. Benefits for sealants include repair or replacement within 24 months by the same dentist or dental office.

If you haven’t already, consider offering sealants as a part of your employees’ coverage. If your plan covers sealants, educate employees about this valuable benefit. Share this flyer about sealants by email, or post it on your company’s website or intranet.

Sealants protect children’s oral health, and that’s a benefit parents will value. With Delta Dental, your employees can find affordable, highly rated coverage for the whole family.

8 ways Delta Dental plans got better for your employees this past year

In a year like 2021, it’s easy to lose track of the updates that help your employees make the most of their Delta Dental plans. From telehealth to online resources, here are eight ways Delta Dental made it easier than ever for your employees to maintain a healthy smile.

1. Teledentistry lets employees use their benefits outside of the dentist office

In 2021, Delta Dental launched not just one but two teledentistry initiatives. Available under Delta Dental PPO™ and Delta Dental Premier® plans, Toothpic and Delta Dental – Virtual Consult let members use their existing diagnostic and preventive benefits to see Delta Dental dentists remotely at no cost.

Toothpic is perfect for members who just need a quick check-in, and Virtual Consult is great for members with more serious concerns that may require a prescription for treatment.

2. New videos make understanding networks and plans easier

The world of insurance can be difficult for people to navigate. As a benefits administrator, you know the value of clear and easy-to-understand communication. That’s why we’ve put together videos that you can share with employees to help them understand the online tools and resources available to them and the differences between the plans we offer.

3. The Delta Dental Mobile App is getting more features and more user friendly

Delta Dental is relaunching the Delta Dental Mobile App for 2022. The new app is faster and more stable and offers useful features such as member ID cards, dentist directory and a cost estimator. It will also be available on both Android and iOS. The old version of the app will be unavailable starting December 20.

4. Delta Dental and VSP are partnering up for paired vision and dental

This year, Delta Dental partnered with VSP to offer vision coverage to Small Business Program (SBP) groups. This coverage is structured in the same tiers as regular SBP coverage, so it’s easy to understand what kind of options are available. If you’re an SBP group and you want vision coverage, you can now get it in one convenient invoice paired with your dental coverage.

5. New open enrollment resources are available

This past open enrollment season brought multiple new features to help employees understand and make the most of their coverage options. In addition to the videos and teledentistry tools already covered, these resources include a new focus on “virtual” booths for open enrollment periods conducted remotely, quality ratings for dentists and refreshed website and customer service experiences. Speaking of quality ratings…

6. DentaQual ratings help employees find dentists they’ll love

This year, Delta Dental added DentaQual ratings to our dentist directory. Your employees can use DentaQual ratings to compare dentists based on objective measurements such as procedures success rate, value and patient retention. These ratings offer a simple and transparent solution to the problem of finding a great dentist.

7. Customer service gets reimagined

After two years of development, design and implementation, we rolled out our new customer service initiative, CX Reimagined. CX Reimagined brought an emphasis on soft skills, like empathy, active listening and de-escalation. Since we rolled out the CX Reimagined initiative, more members than ever before have told us that they’re satisfied with their service and that they’d recommend Delta Dental’s customer service to others. That means that you can feel confident in the quality of customer service Delta Dental provides your employees.

8. Delta Dental’s NCQA Credentialing Accreditation was renewed

Delta Dental Insurance Company’s NCQA Credentialing Accreditation was renewed through March 2024.

“Achieving NCQA Credentialing Accreditation demonstrates that Delta Dental Insurance Company has the systems, process and personnel in place to conduct credentialing in accordance with the strictest quality standards,” said Margaret E. O’Kane, president of the National Committee for Quality Assurance (NCQA).

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA’s Credentialing Accreditation is a quality assessment program that focuses on consumer protection and customer service improvement.


These major updates from 2021 help make Delta Dental plans a choice that will help your employees maintain their oral health and lead to better attendance for your business. We’re proud to be your partners in keeping your employees happy and healthy. Together we shine, and we’ll see you in 2022!

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!

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