Okay, so maybe you didn’t learn everything you need to know about utilization and benefit rates in kindergarten. But you did learn that taking care of your teeth helped you stay healthy. And believe it or not, that fact is often a driving force in the world of dental benefit rates.

Claims and utilization metrics can be viewed as a measure of how well your clients’ employees have learned the “brush your teeth” lesson. They can also play a big role in dental benefit pricing. In order for your clients to balance their benefits costs while offering their employees the best benefits possible, it really comes down to a few basic concepts.

1. Numbers

How are their employees using their benefits? Are most of them visiting for checkups and cleanings, or is there a high number of employees that are visiting the dentist  to treat cavities, periodontal disease or other dental conditions? These numbers represent their utilization of the dental plan.

2. Patterns

By identifying trends, you assist your clients in evaluating their plan performance and making adjustments if necessary. If they have unfavorable utilization patterns, can you help them turn this around by encouraging their enrollees to get preventive care? Should you recommend a change in plan design?  (Hint: Delta Dental can help!)

3. Comparisons

Talk to your clients about how their numbers stack up to carrier and industry benchmarks. These comparisons are an additional factor in determining their rates for new coverage and renewals.

Sounds simple, right? Not exactly. There are a variety of numbers, patterns and benchmarking data to be considered – all of which can affect rates.

And that’s just the beginning. Turns out it’s complicated – maybe it’s not so easy that a kindergartner could understand it. But by working with your clients to make sense of it all, you can help them create strategies that promote savings and happy, healthy employees.

Delta Dental offers comprehensive and easy-to-use reporting to help your clients maximize their benefit dollars.