Broker blog from Delta Dental

Author: Delta Dental (Page 2 of 15)

SmileWay Wellness Benefits help your clients’ 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 clients may be interested in learning how good dental health can improve overall health. If your clients’ employees have medical conditions that affect their oral health, SmileWay® Wellness Benefits may be available to help meet their needs.

Who’s eligible for SmileWay Wellness Benefits?

Not everyone is eligible for SmileWay Wellness benefits. To claim these benefits, Delta Dental members must:

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

Additionally, members must have been diagnosed with any of the following to be eligible for expanded coverage:

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

What are the benefits?

Those whose plans offer SmileWay Wellness Benefits 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 clients have employees whose medical issues necessitate extra dental care, encourage them to consider adding SmileWay Wellness Benefits to their coverage. These benefits can help keep their employees both smiling and healthy!

Common questions clients may have about the COVID-19 vaccine

As the COVID-19 vaccine is becoming more accessible throughout the country, you may find more of your clients and their employees talking about it and asking questions. Unfortunately, there’s a lot of conflicting and inaccurate information being spread through various media channels. Staying on top of the truth can be a full-time job, but here’s a list of common questions and some points you can bring up in case you hear concerns about the vaccine.

Is the vaccine safe?

Yes. Multiple expert sources, such as the Mayo Clinic and the Centers for Disease Control and Prevention (CDC), have attested to the vaccines’ safety. There are multiple reasons given why someone might be concerned about the vaccine’s safety, but the most common include:

  • Concerns about catching COVID-19 from a vaccine shot. There is no live virus used in the vaccines, so people who receive them can’t contract COVID-19.
  • Concerns about the vaccine damaging cells’ DNA. mRNA vaccines don’t alter cell DNA. Instead, they teach cells how to make a protein, which generates a response that will help the immune system target identical proteins in the COVID-19 coronavirus.
  • Concerns about the vaccines being developed recklessly or too quickly. The vaccines have been tested on tens of thousands of patients. Pfizer and Moderna have published ingredient lists for their vaccines, and the mRNA technology used to make the vaccines has been in development for over 30 years.

I’ve heard reports of people having aches, chills and other symptoms after getting vaccinated. Is this an issue?

No. Some people who have gotten the vaccine have reported muscle pain, chills and headaches, but that is not unusual for vaccines. These are part of the body’s normal immune response. But those who have had allergic reactions to vaccines in the past (which are due to the ingredients used in the vaccines), should first consult with their health care providers.

Should I still get a vaccine if I’ve had COVID-19 previously?

Yes. It’s not clear if having contracted COVID-19 previously grants long-term resistance and immunity, like having contracted chicken pox does. Even for those who have been infected previously, the CDC still recommends getting vaccinated.

COVID-19 doesn’t seem that deadly. Should I get a vaccine if I’m not in a high-risk category?

Yes. It’s true that as a percentage, most people who contract COVID-19 don’t die from it. Still, there can be serious long-term consequences such as lung, heart or brain damage. And even someone who doesn’t get seriously ill can still spread the disease among others who are more vulnerable. Getting a vaccine helps us protect not just our families and loved ones, but also society as a whole.

Once I’ve been vaccinated, do I still need to wear a mask or socially distance?

Yes. Even if a person has been vaccinated, that doesn’t mean that he or she can’t still spread the virus. It takes at least 10 days for the body to develop antibodies to the virus, and the number of antibodies present only goes up with more time. Additionally, research hasn’t conclusively determined if the vaccines prevent asymptomatic infection and spread (although it is likely that they do). Wearing a mask and socially distancing are also good behaviors to model for those who haven’t been vaccinated yet. By getting vaccinated and following other preventive measures, we can all do our part to end the pandemic sooner!

I’ve heard that the vaccine contains a chip inside that lets the government and corporations track people who get vaccinated. Is this true?

No. Some syringe makers include a microchip within the labels of their products so that health care providers can track the shipping history and origin of doses of vaccine. There is no chip within the vaccine itself.

I heard that the vaccine targets a protein that occurs naturally in pregnant women and can cause fertility issues. Is this true?

No. An amino acid sequence is shared between COVID-19 and a placental protein found in pregnant women, but the sequence is too short to trigger an immune response by itself. COVID-19 vaccines won’t cause fertility issues in women.

A quick look at people without dental insurance

In 2019, there were almost 74 million people, or nearly 25% of Americans, without dental insurance in the United States. At the height of the unemployment rate’s rise, coronavirus-related job losses and cutbacks left more than 16 million people without dental insurance from an employer. Some of that population will either purchase individual dental coverage, or else find coverage through government plans, but the number of individuals without dental insurance is still expected to increase to as many as 82 million individuals.

Let’s take a closer look at this growing market.

Who are the uninsured?

When examining the 2019 enrollment survey by the National Association of Dental Plans, there are two qualities that jump out when looking at the average uninsured individual.

The first is that people without dental insurance tend to be older than the average American, with an average age of 53.

Second, the uninsured are more likely to be women. Women make up 66% of the uninsured population in America.

Beyond that, the uninsured are a fairly diverse group.

  • Compared to the general population, the uninsured are less likely to be working full-time,with 40% employed and 40% retired. The remaining 20% are unemployed or not working by choice.
  • The uninsured are more likely to be non-Hispanic whites than the general population, at nearly 80% compared to 60.7% for the general population.
  • More than a quarter have children under age 26 at home. Over 40% of the general population has children in this age group at home, so the uninsured are less likely to have children at home than the general population.
  • More than half have some college education. The gap between the uninsured and the general population is very small here. As a whole, just over 50% of Americans over 25 have a bachelor’s degree or higher.
  • More than half of the uninsured are married or in a domestic partnership. A little less than a quarter are single, and the remainder are divorced or widowed.

Why don’t people have dental insurance?

One reason why the uninsured don’t have coverage may have to do with the high average age of the group. They may be retired or reliant on Medicare for insurance, and only Medicare C plans may cover dental. For these individuals, remind them of the low monthly cost of premiums and the size of Delta Dental’s network to help them see that dental coverage is both affordable on a fixed income and easy to access.

There may also be a general lack of information, particularly among those who are retired or jobless and don’t have a benefits administrator to curate plans. Share resources such as Grin! to help them understand why dental coverage is important and what their options are.

Some of the uninsured may have chosen to not have dental insurance, especially if they’ve been looking to cut costs due to changes in their employment status. Over the past year, 39% of Americans reduced or eliminated their insurance for financial reasons, according to Dentistry Today. Of those who have been furloughed or laid off because of COVID-19, this number jumps to 65%.

Common reasons given for choosing not to have insurance include:

  • “My oral health is already good, and I don’t need to visit the dentist.”
  • “Dental insurance isn’t worth the money. I’d rather pay out of pocket.”
  • “I don’t have insurance, because I use a flex spending or health savings account to cover costs.”
  • “The dentist I see isn’t in the insurance network anyway.”

Sharing information about the benefits of dental insurance, even in times of economic uncertainty and the coronavirus pandemic, may help persuade these individuals. You can also remind them that having insurance can be worthwhile because it makes it easier to keep dependents covered, including some adult children.

COVID-19 and the uninsured

The disruptions caused by COVID-19 have affected the uninsured population especially hard. Without insurance to help catch issues early, the uninsured are more likely to have untreated oral health issues and other problems. People with oral health issues and chronic diseases are at higher risk of hospitalization from COVID-19, according to the Centers for Disease Control and Prevention. Having and using dental insurance can help lower the risk of serious complications from COVID-19.

Given that the uninsured population is more likely to be vulnerable to costly dental bills, inadequate dental care and experiencing health issues that go alongside poor oral health, dental coverage is more important than ever before.

Effective discount: Understanding a plan’s true savings

When your group clients 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 speaking with your group clients: Savings is more than PPO discounts. When you consider effective discount, you offer a complete story. One with an ending your clients should like.

Why companies need ancillary benefits

Dentist documents findings during an exam with patient.

By offering companies a way to enhance their employee benefit package, you are providing them a marketplace advantage for retaining a motivated, healthy workforce.

Nearly 60% of responding hiring managers, human resources professionals and workers identified better benefits as a key strategy to strengthen connections with employees and reduce turnover, according to a 2018 Career Builder survey. To achieve this goal, companies are looking to add ancillary benefits.

What are ancillary benefits?

An ancillary benefit covers a specific need not addressed by the group medical insurance plan. Dental, vision, life, disability and even pet insurance are complementary products that can be integrated into company benefit packages.

This is how companies can strengthen connections with their employees. Ancillary benefits deliver value through access to health care plans and financial solutions that enhance total wellness, lower out-of-pocket expenses and give peace of mind.

What is the value of an ancillary benefit?

Through ancillary benefits, companies show that their priorities match employees’ priorities. According to an American Dental Association survey, 30% of young adults have tooth decay, 35% reported difficulty biting or chewing and feeling embarrassment at the condition of their teeth and 59% of respondents reported cost as the top reason for not visiting the dentist. 

Companies saved $5.8 billion over four years by offering stand-along vision plans, according to a study by the HCMS Group. Widespread computer use can lead to digital eye strain, and plans generally include coverage for a comprehensive eye exam, contact lenses or glasses, and allowances for LASIK or PRK refractive surgery.

Although 75% of millennials don’t carry life insurance, this benefit becomes more important to them in later stages of their careers. The average worker has a 30% chance of becoming disabled, so a short-term or long-term insurance plan provides backup. Millennials make up 35% of all pet owners, and a 2018 survey by the Society of Human Resource Management revealed that 11% of U.S. employers offered pet insurance, up from 6% in 2014, and one in three Fortune 500 companies offered it.

Companies can use surveys to find out what employees are seeking, and then shape ancillary benefit options accordingly. You can help employers achieve their strategic goal by providing what their employees want.

Why should companies offer ancillary benefits?

As an ancillary benefit, a dental insurance plan, for example, includes diagnostic and preventive services that go beyond maintaining employees’ oral health. Dentists not only evaluate periodontal disease but also diagnose symptoms of major health issues, such as diabetes, during routine exams. Early detection enables employees to seek treatment that may avoid more expensive interventions. It can help your company control long-term health care costs and provide financial stability for employees.

In a vision insurance plan, an annual eye exam can reveal symptoms of chronic conditions such as diabetes, high blood sugar or high cholesterol.

When you show the return on investment in an ancillary benefit to a company, through cost of premiums versus cost of claims, it can support the case for adding it for employees. You can offer a Delta Dental plan that easily complements, and integrates with, an existing group medical plan. This ancillary benefit can increase both workers’ job satisfaction and wellness.

New videos help explain Delta Dental’s networks and online tools

With a new series of educational videos, it’s easy to help your clients make the most of their plans. Whether your clients offer Delta Dental PPO™, DeltaCare® USA or both, you’ll find useful resources to showcase Delta Dental’s networks and online tools.

Get to know Delta Dental’s online tools

Encourage members to sign up for an online account. This video walks members 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 client’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. This video explains the advantages of this plan and how your clients’ enrollees can find a PPO dentist online.

Want to include the Delta Dental Premier® network to offer a wider selection of dentists? This video introduces both the PPO and Premier networks and explain how to search for both in our dentist directory.

For clients that offer a DeltaCare USA plan, this video covers the basics of this prepaid plan and shows 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 easily

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.

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