Broker blog from Delta Dental

Category: Group dental coverage (Page 1 of 6)

Help group clients promote preventive care with the D&P Maximum Waiver

When it comes to using their benefits, it’s important for your group clients’ 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.

Unfortunately, your clients’ employees may not want to use their diagnostic and preventive benefits because they want 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. That means more savings for your clients.

What is the D&P Maximum Waiver?

The D&P Maximum Waiver is an optional feature that can be added to Delta Dental PPO™ group plans. With this option, diagnostic and preventive services won’t count against members’ annual maximums. 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 groups and members?

The D&P Maximum Waiver option is a great way to help your group clients promote diagnostic and preventive services — and avoid lost productivity from dental issues.

By ensuring that D&P procedures don’t count against their annual maximums, the D&P Maximum Waiver leaves members with 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: $350Member annual maximum: $1,000Member’s plan pays: $350Member pays out of pocket: $0Member’s remaining annual maximum without D&P waiver:
$650
Routine dental exams, cleanings and x‑rays cost: $350Member annual maximum: $1,000Member’s plan pays: $350Member pays out of pocket: $0Member’s remaining annual maximum with D&P waiver:
$1,000
With the D&P Maximum Waiver, members have more of their annual maximum left after getting diagnostic and preventive care.

If your group clients would like to promote in-network utilization, the D&P Maximum Waiver can be set up to only apply at Delta Dental PPO dentists. Adding the D&P Maximum Waiver option to their coverage also helps your clients save money by letting employees’ dollars go farther without having to pay more for a higher annual maximum.

Reach out to your Delta Dental Account Executive today to learn more about offering this feature.

6 common questions about adult orthodontics

Adult orthodontics has become a popular benefit enhancement in recent years. Adults are opting for orthodontic treatments at higher numbers than ever before, and the number seeking treatment is expected to grow in the next decade.

If you have individual or group clients who are interested in adult orthodontic treatment and coverage, they may have some questions. Here are answers to some of the most common questions about adult orthodontics.

Which Delta Dental plans cover adult orthodontics?

Adult orthodontic coverage is available for both Delta Dental PPO™ and DeltaCare® USA group plans. For individual plans, adult orthodontics is covered under the PPO Premium Plan and DeltaCare USA plans

Why should groups offer coverage for adult orthodontics?

Braces can help to treat problems that weren’t treated when patients were younger. An adult with an overbite or underbite, crooked teeth or a misaligned jaw may benefit from orthodontic treatment. Left untreated, these issues may contribute to serious conditions such as tooth decay, headaches and earaches, chewing issues and gum disease.

Are adult orthodontics more expensive than treatments for kids?

The cost of braces depends on clients’ plans. A pre-treatment estimate can provide clients with a good sense of how much the costs will be before treatment begins. All they need to do is ask their orthodontist’s office to submit a pre-treatment estimate to Delta Dental.

Members can also use the Cost Estimator tool to get a sense of how much their orthodontic treatment will cost.

Can members visit any orthodontist? How can they find an orthodontist?

Delta Dental PPO plan members can see any licensed orthodontist, and they’ll usually save the most when they choose a Delta Dental orthodontist. To find one, they can use the Find a Dentist tool. They just need to search for dentists in the Delta Dental PPO network, then refine their results to include providers with orthodontist as their specialty.

DeltaCare® USA plan members must see their chosen DeltaCare USA dentist for care or get a referral to a specialist for their care to be covered by their plan. If they’ve already begun orthodontic treatment outside of the DeltaCare USA network and have been banded, most plans allow them to continue that treatment with the same coverage and copayments as their previous plan. If banding has not yet taken place, the member must visit a DeltaCare USA orthodontist and pay the copayments listed in their DeltaCare USA plan booklet.

Is Invisalign a covered benefit?

Yes. If a member’s plan includes adult orthodontic coverage, “invisible aligners” like Invisalign are covered as a standard benefit. For plans where alternative appliances aren’t covered, Delta Dental usually covers some of the costs of orthodontic treatment, which can help to reduce members’ overall expenses.

What kind of orthodontic coverage is included in Delta Dental plans?

As with costs, coverage varies, but most Delta Dental plans include:

  • Pre-orthodontic treatment visit
  • Exam and start-up records
  • X‑rays
  • Orthodontist-recommended tooth extractions
  • Comprehensive orthodontic treatment
  • Post-treatment records

Plans usually cover one set of post-treatment retainers. For two-phase orthodontic treatment plans, retainers are usually covered after each phase.

Adult orthodontics aren’t commonplace yet, but they don’t have to be confusing! With these questions answered, your clients will be better able to decide if orthodontic treatment is right for them.

Affordable dental benefits for small businesses

The overall economy might be strong, but that doesn’t mean businesses of every size aren’t feeling the pinch from inflation. The inflation rate jumped from 1.4% in 2020 to 7% in 2021, and it’s on track to be even higher in 2022. In this environment, it’s natural for businesses to look for ways to cut costs and save money.

Thankfully, Delta Dental’s Small Business Program (SBP) plans mean that dental benefits don’t have to be a casualty. With our SBP plans, it’s never been easier for your clients to help protect employees’ smiles without breaking their budgets.

What is the Small Business Program?

The Small Business Program is Delta Dental’s plan offerings for businesses with two to 99 employees. These plans are designed to be flexible so that your clients can choose the options that make the most sense for their businesses. They’ll be able to save money while still offering their employees great coverage.

What kind of coverage options are available?

SBP dental plans are available in a three-tier structure to meet clients’ needs regardless of budget. Delta Dental PPO™ and DeltaCare® USA plans are available at each tier.

If your clients are looking for more, they can pair their Delta Dental plan with a DeltaVision plan (please note, only plans administered by Allied Administrators are eligible for DeltaVision pairings). There are also options with Delta Dental PPO plans for voluntary benefits, where employees pay anywhere from 50% to all of the premiums.

For more details, explore our SBP plan comparison.

Why should businesses offer dental coverage when budgets are tight?

Offering dental benefits can help your clients save money over the long run. Each year, over $45 billion is lost in productivity because of dental issues, according to the Centers for Disease Control and Prevention. Employees without coverage may avoid going to the dentist or delay care because of the cost, which can result in more severe dental issues and more time off work. In contrast, employees with dental coverage are more likely to visit the dentist and maintain a higher level of health and wellness.

With SBP plans, any of your clients can help employees stay healthy — and their budgets to stay in check!

Dental and vision, together

Did you know that Delta Dental offers a vision benefit for small businesses? By pairing vision with a dental plan, this package offers small business clients a single invoice with great rates. Here’s what you need to know about DeltaVision, Delta Dental’s vision offering.

Who’s eligible for DeltaVision?

DeltaVision is offered through our Small Business Program (SBP), designed for groups of two to 99 members. DeltaVision plans are available to brokers working with Allied Administrators.

Paired plans are available in the District of Columbia and the following 14 states: Alabama, California, Delaware, Florida, Georgia, Louisiana, Montana, Maryland, Nevada, New York, Pennsylvania, Texas, Utah and West Virginia.

Why get a DeltaVision plan?

DeltaVision plans offer:

  • Great coverage and extensive network access. All DeltaVision plans are offered on VSP’s Choice nationwide network and include access to over 100,000 access points and popular benefits such as exams, lenses and allowances for frames or contact lenses.
  • Extra savings. DeltaVision plans offerextra savings on additional pairs of glasses, sunglasses, routine retinal screenings and laser vision correction.
  • Flexible funding. With a wide range of DeltaVision plans available, your clients can choose the plans that fit their needs and budget.Voluntary and employer-paid options are also available. Our Easy Options plan lets members choose an upgrade for frames, contact lenses, anti-reflective lenses, progressive lenses or photochromic lenses at the time of service with their VSP network doctor.
  • Added wellness benefits. Through the Diabetic Eyecare Plus program, retinal screenings for people with diabetes are available at no cost, as are extra exams and services for those with diabetic eye disease, glaucoma or age-related macular degeneration.

Ready to pair DeltaVision with dental for your small business clients? Contact our Sales team for more information.

Take the mystery out of dental expenses with the Cost Estimator

Your group clients’ members are busy enough, so trying to figure out how to budget their dental care shouldn’t become a second job. That’s why we created the Cost Estimator, a tool available for desktop and mobile that members can use to estimate quickly and easily what their next dental visit will cost.

What’s more, the Cost Estimator has just been refreshed with a new, accessible and mobile-optimized design.

How can the Cost Estimator can help members?

The Cost Estimator provides members with a personalized estimate (based on the fee schedule from the last dentist from whom they received service) for an entire dental visit with a specific dentist. It calculates members’ out-of-pocket costs based on their current benefits. Information is updated daily, so members can always count on getting an accurate cost estimate.

This versatile and easy-to-use tool offers members a variety of useful features and information to help them make the most of their benefits and helps them become better informed consumers.

In the tool, clients can choose from a list of common dental procedures ― they can even specify which tooth needs treatment or what type of filling they’d prefer! After they select their procedure, the Cost Estimator calculates their estimated out-of-pocket cost. The tool subtracts both the network savings and the portion the plan pays.

Other tasks your clients can perform with the Cost Estimator include:

  • Adding procedures. If clients need to add services such as a cleaning or x‑rays to their visit, they can add them to their estimate to get the total cost of the visit.
  • Comparing dentists. Clients might be curious to see if they’d save by switching to another dentist. The Cost Estimator lets them compare up to five in-network dentists to find the best deal.
  • Selecting plan members. Clients can get cost estimates for anyone on their plan, such as spouses and children.
  • Reviewing benefits usage. Clients can access the benefits activity and history for everyone on their plan, and can also review their plan’s maximums, deductibles and out-of-pocket limits.

How can the Cost Estimator help my group clients’ bottom line?

The Cost Estimator provides members with transparency about their out-of-pocket costs. More cost transparency can mean fewer questions and less confusion about the value of visiting an in-network dentist. By showing the substantial cost differences between in-network and out-of-network dentist visits, the tool encourages in-network utilization — which can help members save and may help lower group dental plan costs.

Which clients can use the Cost Estimator?

All Delta Dental PPO™ and Delta Dental Premier® groups are eligible to sign up for the Cost Estimator. DeltaCare® USA members receive a plan booklet with their copayments for covered services, so this tool isn’t necessary for DeltaCare USA plans.

If you have group clients that haven’t taken advantage of the Cost Estimator, explain to them the cost-saving benefits of this tool. For details, talk to your Sales representative about how your clients can add this service to their plan.

How do members access Cost Estimator?

To use the Cost Estimator, members simply click Plan ahead for a visit from the member portal. PPO and Premier members can also access a more limited version of the Cost Estimator through the Delta Dental mobile app, which details in- and out-of-network fees.


With the Cost Estimator, your clients can be confident that their members are not only about staying within their budgets, but also that they’re getting the best deal for themselves and their families. Be sure your group clients don’t miss out on this valuable resource.

Why dental insurance makes financial sense

When explaining the value of a dental plan to group members, you may come up against resistance. People often understand that they need health insurance, but they may not recognize the value of dental insurance. But dental coverage not only helps members protect their teeth. It can also save them money and prevent a mouthful of financial problems.

Let’s crunch the numbers

For about $33 per month — the average premium for a member covered under an employer-sponsored Delta Dental PPO™ plan — group members can receive coverage for a variety of dental services. That’s the cost of two sugar-filled lattes every week. And what will that cover?

New patients typically need dental exams, cleanings and x‑rays. Uninsured patients might pay an average of $95 for an exam, $172 for a set of four bitewing x‑rays and $102 for a professional cleaning.

If you add up the numbers, that’s $369 for one visit — almost an entire year’s worth of premiums. Considering they’ll usually need two cleanings per year, the costs could potentially add up to $566 for an uninsured person.

But under most Delta Dental PPO plans, diagnostic and preventive services are covered at 100%. That means that even with premiums, patients will be paying 30% less than they would out of pocket.

These costs are illustrative, and plan coverage varies.

Serious dental procedures add up

The value of dental insurance, however, goes beyond diagnostic and preventive care.

Filling a cavity can cost an uninsured patient anywhere from $243 to $296, depending on how many surfaces need to be filled. That same procedure for an insured patient may cost about $30, based on Delta Dental PPO nationwide averages. That’s $266 in savings for each filling.

A root canal and a crown for an uninsured patient may cost about $2,644. But for Delta Dental PPO members, out-of-pocket costs average $564 — which means $2,080 in savings.

And Delta Dental members enjoy additional savings. In-network dentists can’t charge members above preapproved, discounted rates. For uninsured patients, there are no limits to what dentists can charge them.

Dental insurance equals healthier teeth

Adults with dental coverage are almost a third more likely to go to the dentist as those without coverage, according to a 2020 report released by Delta Dental Plans Association. How does this affect group members’ pocketbooks?

Untreated dental care can be costly. More than a quarter of all Americans have untreated tooth decay, according to the Centers for Disease Control and Prevention. Almost half of all people over 30 years old have signs of gum disease. The less likely members are to visit a dentist, the more likely they are to have costly problems that will eventually need to be treated.

Remember these stats when you’re talking about dental insurance with your group clients. It’s not just about peace of mind. It really makes financial sense to get coverage, and it may even encourage members to go to the dentist and keep their teeth and gums healthy.

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