Broker blog from Delta Dental

Author: Delta Dental (Page 3 of 17)

Your clients can now pair their Delta Dental coverage with VSP vision

Helping your small business clients find the right insurance coverage can be complicated, but Delta Dental is making it simpler. Delta Dental’s Small Business Program (SBP) dental plans and VSP® vision plans are available paired together through the Allied Benefit Suite. It’s never been simpler to offer your clients comprehensive plans from two industry leaders in a single itemized invoice. Here’s a quick look at answers to common questions.

Where are paired plans available?

Vision plans are available in all states that our SBP dental plans are offered and administered by Allied Administrators. Vision coverage is not available on its own. It must be paired with dental. Vision coverage can also be added to existing SBP plans administered by Allied Administrators.

What kind of coverage do these plans offer?

These new vision plansfeature comprehensive coverage on VSP’s nationwide network. They’re available in the same three-level structure as SBP dental plans (Deluxe, Advantage and Core), so you don’t have to worry about learning a new system and explaining it to your clients. These levels allow for flexibility based on your clients’ budgets and needs, including voluntary or employer-paid options, and can be paired with any level of SBP dental plan.

What kind of benefits are included?

Benefits vary by level, but every vision plan includes:

  • Coverage for an annual eye exam and lenses
  • A frame or contact lens allowance (contact lenses are available in place of lenses and frames)
  • Access to VSP’s nationwide network

With VSP vision coverage paired with to their Delta Dental SBP plans, your clients will enjoy simpler billing and more care for their employees, and you’ll get to offer a more attractive package to your clients. If you want to learn more or get a quote, visit our Sales Contact page. It’s easy to see that’s a win-win.

Vision coverage is provided by VSP.

©2021 Vision Service Plan. All rights reserved.

VSP is a registered trademark of Vision Service Plan.

Delta Dental’s NCQA Credentialing Accreditation renewed

Delta Dental Insurance Company’s NCQA Credentialing Accreditation has been 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.

NCQA has reviewed and accredited Delta Dental Insurance Company’s Credentialing functions only. For complete details on the scope of this review, visit www.ncqa.org.

Dental care for the deaf and hard-of-hearing

Happy National Deaf History Month! If you haven’t heard of this season, it runs from March 13 to April 15. Nearly 15% of adult Americans report trouble hearing, so your clients may have employees with hearing issues and aren’t even aware of it! Deaf and hard-of-hearing individuals face some unique challenges when it comes to getting dental care. Even making an appointment can be difficult. Fortunately, there are solutions available to ensure that no problem is insurmountable. Here are some of the common issues that people who are deaf and hard of hearing can encounter and what Delta Dental does to help solve them.

Challenges and considerations

When it comes to getting quality dental care, challenges can start before people who are deaf and hard of hearing ever set foot in the office.

  • The deaf and hard-of-hearing can have difficulty just making appointments. Not every office will have someone fluent in American Sign Language (ASL) on staff, but if an office isn’t set up to schedule appointments by text or email, it can be impossible for deaf patients to even step foot inside.
  • Dentists that don’t speak clearly, slowly and while looking at members make it hard to read lips. The deaf and hard of hearing may rely more on lip-reading than others. Seeing a dentist who is in a hurry or who talks while moving all about the practice can make it more difficult for the deaf and hard-of-hearing to follow what’s being said. To make things even harder, the fact that everyone is wearing masks because of COVID-19 only compounds this issue.
  • People may not even realize that they’re hard-of-hearing. Because most everyone loses some of their hearing as they get older, the change can happen so gradually that some people aren’t even aware of it. Attentive dentists can notice when their patients seem to have difficulty with hearing them or following a conversation and adjust accordingly.

Solutions and resources

Whether a person has recently become hard of hearing or has been deaf since birth, there are two major tools available to help them.

  • The Language Assistance Program (LAP). The LAP is a free service that Delta Dental members can use to get professional interpretive services for their non-English needs. This includes phone assistance, written materials and more, including an in-person translator when given 72 hours’ notice. Most importantly for deaf patients, this means that they can have an interpreter fluent in ASL accompany them to their dental visits!
  • The Find a Dentist search tool. The Find a Dentist search tool is perfect for members looking to find an in-network dentist that fits their specific needs. Members can search by distance and specialty, but they can also search for dentists by the languages their offices support and available accessibility features, including dentist offices where the staff is fluent in ASL!

More than 35 million people in the United States report having trouble hearing, whether they suffer from mild hearing loss or are completely deaf, so it’s essential for your clients that their dental coverage take this into consideration. Fortunately, valuable services like the Language Assistance Program and thoughtful features like the Find a Dentist search tool make it easier for deaf and hard-of-hearing members to get their dental needs taken care of.

Client considerations for COVID-19 vaccines

The speed and efficacy with which COVID-19 vaccines have been developed is a testament to human ingenuity and the drive to create a safer world for us all. The three vaccines that are widely available in the U.S. (Moderna, Pfizer and Johnson & Johnson) have all received emergency authorization by the FDA after demonstrating both efficacy and safety, but there are other issues your clients may want to consider when deciding on how to approach a vaccine policy.

What options do employers have?

There are three main courses of action your clients could take when it comes to employees and vaccines:

  • Do nothing. This means choosing not to implement a company-wide vaccine policy and not advocating for and encouraging vaccinations. Doing nothing may not be the optimal choice from a public health perspective, but it’s certainly a valid one from a legal standpoint. Mandating or incentivizing vaccination could help to reduce increased costs or absenteeism from employees, but it can also lead to exposure to legal liability depending on how such policies are implemented (and how litigious employees are).
  • Encourage and incentivize vaccination. This is a gentler approach than outright mandating vaccinations as a condition of continued employment. Encouraging employees to get vaccinated is legally safe, although it may run the risk of upsetting employees who don’t believe in vaccination, who have concerns about vaccine safety, who have health considerations that keep them from getting vaccinated or who simply don’t like feeling pressured when it comes to managing their health. Incentives, such as offering paid time off or a bonus to employees who get vaccinated, must be carefully implemented, however. Aside from the cost considerations that comes with bonuses and incentives, employers may find themselves legally liable for any issues that arise from implementing on-site vaccinations.
  • Mandate vaccination. This is an aggressive option, but it’s certainly the most effective from the point of prioritizing the health and safety of employees. Mandating that employees get vaccinated is generally legal (although it may not be in some states), but it’s possible that some implementations could put your clients at legal risk (for example, setting up on-site vaccinations or inquiring about employees’ personal health to determine their eligibility for vaccination).

Which employees should get vaccinated first?

Until vaccines become more widely available, it’s best to prioritize employees who are most vulnerable to exposure and at greatest risk of complications from COVID-19. Of course, in health care and senior care industries, everyone with regular contact with the ill and elderly should be vaccinated. Outside of these industries, your clients should consider prioritizing:

  • Employees who work in close physical contact
  • Employees who have regular exposure to customers and other members of the public
  • Employees who have regular exposure to heavily trafficked enclosed spaces, food products or other settings where infection may be a risk
  • Employees who are 65 or older
  • Employees who are 16–65 with underlying medical conditions that increase the risk of life-threatening COVID-19 complications

What are the risks of implementing a vaccine policy?

Your clients could get into legal trouble if pre-screening vaccination questions aren’t job-related and consistent with the requirements of their businesses. To avoid this outcome, they should make sure that any pre-screening questions are related to the job and that they can prove that unvaccinated employees pose a direct threat to the health and safety of other employees. Similarly, your clients could get into legal trouble if they attempt to prevent workers’ concerted activity, such as expressing opposition to mandatory vaccines.

Employers should make sure to follow state and local laws, as well. Some locales may have prohibitions against mandating vaccines that more strict than state or federal law.

Setting a policy and moving forward

Before settling on the policy that’s best for their company and their employees, there are a few final things your clients should consider.

  • Make sure to follow all federal, state and local laws. Your clients won’t want to put their organization at risk of legal exposure. It’s best to do some research and stay up-to-date on the latest laws and regulations.
  • Get a sense of how their employees feel. If your clients have employees who feel very strongly about vaccines, either adopting a mandatory policy or doing nothing may cause disquiet. Taking surveys of employee sentiments can be a good way to decide how to craft a message.
  • Identify who should be doing the communication. Figures like respected managers, team leaders and union officials can be excellent ambassadors for company policies, especially in larger organizations where employees may not have personal relationships with upper management.
  • Be transparent. As always, communication is key when it comes to rolling out new policies that can affect employees’ work lives. Your clients should let employees know both what their COVID-19 vaccine policy is and how that position was reached. They should be sure to listen to and address employee concerns, even if the company’s policy remains firm.

Regardless of what policy your clients decide to implement, wearing masks and respecting social distancing will stay important aspects of infection management. Even as vaccines become more readily available, maintaining practices and procedures to minimize the chance of infection and help their entire organization stay healthy is essential.

How are dentists recovering from the pandemic?

In the months since the coronavirus (COVID-19) pandemic entered the United States, the future of the dental industry has been on relatively shaky footing. But despite fluctuating patient volumes, lower than normal dental spending and large-scale coverage losses across the country, outlooks for the future are looking positive as recovery from the pandemic gains momentum.

Patient volumes are increasing

For the first time since late March 2020, slightly more than 50% of dental practices are open with pre-pandemic patient volumes, according to the American Dental Association (ADA)’s report COVID-19: Economic Impact on Dental Practices, Week of March 15. With less than 1% of practices fully closed, over 99% of practices are now open and seeing patients.

A year ago, during the week of March 23, 2020, the ADA reported that 19% of practices were fully closed and 76% of practices were only seeing emergency patients. In the following months, practices began to reopen and saw slow but steady increases in patient volumes. By late August, almost half of practices were open with normal patient volumes. That percentage dipped down again in November, but slightly more than half of practices are now operating at their pre-pandemic levels.

Due to cancellations during the second and third quarters, many practices saw holes in their schedules during the fourth quarter of 2020 and the first quarter of 2021. Usually, a practice would have 80% or more of its schedule filled. The past year was much different, with the average schedule only 50% full. This dip occurred in part because some appointments in the first half of 2020 were cancelled due to the pandemic and then the appointments were not immediately rescheduled.

In good news, nearly three in every four patients believe that routine dental appointments are still important during the pandemic, according to a September 2020 survey by the Delta Dental Institute. Most respondents said they were worried about the long-term side effects of missing appointments. The results of this survey may suggest that patients will continue to return to dentists.

Dental care spending dipped in 2020

The dip in patient volume also a contributed to a projected dip in yearly dental spending. The ADA’s Health Policy Institute predicted in its June 2020 industry model that dental care spending would dip by up to 38% in 2020 and 20% in 2021. Their models didn’t take into account additional waves of COVID-19 cases. However, dental spending in 2020 dropped by 20%, a large drop but significantly less than the amount predicted by the ADA.

Compared to other health services, dental services had the largest decline in spending, possibly related to practice closures and patient anxieties about infection while receiving care.

Changes in coverage may have contributed to decline

Disruptions of the job market and financial instability caused by the pandemic have altered the insurance market. Almost 7.7 million workers with employer sponsored insurance (ESI) lost their coverage due to the pandemic. An additional 6.9 million dependents lost their insurance coverage when their family members lost jobs.

In the past year, 39% of Americans have chosen to reduce or eliminate their insurance for financial reasons. Some people see dental insurance as an additional cost that isn’t worth it when their oral health is currently good or their dentist isn’t in-network.

The strong link between employment and health insurance coverage has important implications for Americans’ insurance coverage and access to health care, as ESI is the most common form of health insurance in the United States. It’s also crucial that patients understand the connection between oral health and overall health as they make choices about their coverage.

Low risk of infection in dental practices

Despite dentistry being flagged as a high-risk profession for COVID-19 infections, the estimated rate of COVID-19 cases among dentists was less than 1%, according to a November 2020 study in JADA. Low rates of infection, about 3%, were identified in dental hygienists as well, according to a study published in the February 2021 issue of The Journal of Dental Hygiene.

These statistics suggest that enhanced infection control measures implemented by almost 99% of practices helped prevent infections in dental settings. Low rates of infections paired with the fact that nearly 80% of dentists have now received at least one dose of a COVID-19 vaccine, dental practices are very safe for patients and staff.

Positive outlooks for the future

There’s a bright light at the end of this long tunnel. About 44.9 million people have been fully vaccinated in the US and an additional 82.7 million people have received at least one dose of a COVID-19 vaccination. A large push to have enough vaccine doses for every American by May 1 may contribute to higher patient volumes in the second half of 2021. Additionally, 70% of Americans intend to get vaccinated or already are. Economic supplements and stabilizers from the federal government will potentially ease stress for some Americans who may be avoiding appointments for financial reasons. With fears of COVID-19 infection at the dentist easing, the future is looking bright for dentists who want patients back in their chairs.

The 2020 elections and the Democrats’ clean sweep: What’s at stake for dental insurance

In an earlier Insider Update article, we considered three possible outcomes of the 2020 United States elections and some possible implications of each.

Since then, the Democratic Party has gained control of the Senate, while winning the White House and keeping control (just barely) of the House of Representatives.

From the Delta Dental perspective, this “clean sweep” impacts all our stakeholders, including dentists, enrollees and our group customers. What follows are some potential opportunities and challenges that may affect you.

The Affordable Care Act (ACA) and the health insurance marketplace (exchange) system will be preserved and expanded

President Joe Biden’s administration has made restoring the ACA an immediate priority, and many of the cuts and restrictions imposed by the administration of former President Donald Trump are being reversed.

This is a positive development for the dental industry, said Jeff Album, Vice President of Public & Government Affairs for Delta Dental.

“News that’s good for the ACA and good for the exchanges is good news for the industry,” Album said. “This market and the increased subsidies attract people who wouldn’t otherwise get insurance.”

Among the ACA-related actions that are either underway or soon to happen under this administration:

A special enrollment period to increase exchange enrollment is officially underway

Biden signed an executive order to create a special enrollment period from February 15, 2021 through May 15, 2021, during which eligible people can enroll in coverage from the federal health insurance marketplace. Uninsured residents in the 36 states that use the federal exchange system, including those who lost coverage because of the pandemic, can look for plans.

States with their own marketplaces are also creating special enrollment periods, although the time frames and eligibility requirements may differ.

The Centers for Medicare & Medicaid Services (CMS) has earmarked $50 million for outreach and education during the enrollment period.

The ACA’s Navigator Program will return

Reversing the prior administration’s move to defund this program, CMS will now provide about $2.3 million to help people find coverage on the federal exchanges, a process that can be confusing. The money will fund 30 Navigator Programs in 28 states. This, Album said, should help bolster dental enrollment.

“Several studies suggests that consumers are completely unaware of marketplace open enrollment dates, including the special enrollment periods,” Album said. “We believe this type of outreach will definitely help promote adult dental voluntary enrollment.”

Subsidies for exchanges will increase

The $1.9 trillion American Rescue Plan Act of 2021 (ARP), which Biden signed into law on March 11, includes increases to ACA subsidies. Consumers with household income more than 400% the federal poverty threshold (about $51,000 per year) will receive federal assistance to ensure that no more than 8.5% of their income goes toward a plan.

“The subsidies are getting better and the Biden administration is trying to bring more people into the exchanges,” Album said. “A great many small business and individuals impacted by the economy and COVID will now have an opportunity to get exchange-based dental coverage.”

Waivers that allow states to circumvent exchanges may be eliminated

Section 1332 of the ACA permits states to apply for a waiver to pursue “innovative strategies” to provide their residents with access to affordable health insurance, so long as they retain the basic protections of the ACA.

However, in 2020, the state of Georgia used the 1332 waiver to effectively eliminate its exchange program and force Georgia residents to purchase plans from private insurers without any kind of centralized platform. As a result, Biden directed federal agencies to reexamine all waiver policies, including 1332.

“I think this administration is going to be tougher than the former one when it comes to deviating from the ACA’s framework,” Album said. “We’re not likely to see any other states attempt a direct enrollment alternative to centralized state-based exchanges or the federally facilitated exchange.”

Medicaid eligibility under the ACA will expand

The ARP also includes incentives to encourage states to expand Medicaid eligibility under the ACA. States that choose to expand would receive a 5‑percentage-point increase in Federal Medical Assistance Percentage (FMAP) payments to current Medicaid enrollees.

“The FMAP increases are important because that’s what allows states to do optional benefits like adult dental,” Album said. “Here in California, the adult dental Medicaid program was going to be in trouble if the state didn’t receive more financial assistance.”

A “public option” with a dental benefit could be created — but probably won’t

A public option would be a federal health insurance program offered on states’ exchanges as an alternative to private plans. It would probably be subsidized for lower income Americans and at least partially paid for by enrollees who don’t qualify for subsidies.

While dental coverage wouldn’t be a guaranteed benefit for anyone other than children, it could be made available on a voluntary basis.

Initially, it seemed as though a clean sweep by the Democrats would almost guarantee a public option. Candidate Biden repeatedly said he supported it during his 2020 campaign. And California Attorney General Xavier Becerra, Biden’s pick for Secretary of the U.S. Department of Health and Human Services and a long-time proponent single payer health care, said during a recent Senate hearing that he would support Biden’s efforts to do so.

However, the Democratic sweep in the 2020 election might not be enough to push this through. Despite their control of the Senate, the Democrats depend on the tie-breaking vote of Vice President Kamala Harris. Furthermore, the Democratic majority in the House narrowed significantly, which increases the leverage of moderate Democrats who aren’t enamored with the public option.

“Given the Democrats’ razor-thin majority in both the Senate and the House, and Republican opposition to the concept, a public option currently seems unlikely,” Album said. “I don’t see it happening.”

Leaving the ACA, here are a few other possible issues likely to come up for Congress and the new administration to consider that may potentially impact dental insurance.

A dental benefit could be added to Medicare

Democrats in the House and Senate have introduced bills to add dental under Medicare Part B. As introduced, these bills do not specify which benefits should be added, which makes it difficult to assess whether the proposals help or hurt existing Medicare Advantage dental plans.

“Neither the House nor the Senate is likely to take these bills up in earnest until the latter half of the year,” Album said, “but our goal will be to participate in discussions yet to come on how the industry can help facilitate bringing dental care to seniors without disrupting existing, successful programs.”

Questions remain

As with any new administration, there are more questions than answers at this point, and how — or if — some of these proposed changes will be implemented is uncertain. What is certain, however, is that we can expect more proposals and policy updates that will affect the dental insurance industry in the upcoming months. Be sure to refer back to Insider Update for news and updates as they become available.

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