Broker blog from Delta Dental

Tag: Devin McBrayer

Policy pops: How does dental fit into the gig economy?

3‑minute read

Join our guest blogger, Devin McBrayer, as she explores the role of dental benefits in the fast-growing gig economy. Devin is a Legislative and Policy Analyst based in Sacramento, California.

The large majority of Americans have dental benefits — 77% in fact, according to the National Association of Dental Plans. Most Americans receive this coverage through their employer or groups like AARP. However, the job market is changing. Each year, more Americans are leaving traditional workplaces to join the gig economy and be their own boss. This shift could change the landscape of the benefits industry in the very near future. 

Who’s in the gig economy?

Nearly one quarter of Americans earn some or all of their income in the gig economy, Edison Research estimates. Not surprisingly, a 2019 survey by Bankrate shows that almost half of Millennial workers work in the gig economy in some capacity. While that’s more than any other generation, a 2018 Prudential study notes that Gen X‑ers work the most hours per week in their gig jobs of any generation and are also more likely to rely exclusively on gig work for income. Baby boomers tend to use gig work to make extra money in retirement. 

Do gig jobs offer dental benefits?

The increasing number of Americans working odd jobs for TaskRabbit or driving for Uber may not receive traditional employee benefits, including dental coverage. That can cause anxiety, when an estimated 44% of American gig workers rely on the gig economy as the sole source of their income. Gig workers might be able to afford to purchase individual dental coverage directly from a carrier or through their state’s exchange, but for some, that coverage might be more than they can afford. A 2017 study by Freelancers Union & Upwork found that over half of freelancers dipped into their savings each month to make ends meet.

On the other end of the spectrum, the gig economy workers using their gig to supplement their income from a more traditional employer may already have dental benefits from their primary job. If not, they may actually use the extra cash to purchase individual coverage.

What does the trend mean for benefits brokers?

Gig workers, especially those who have never had access to employer-sponsored benefits, may need education about the value of dental coverage. Adults with dental benefits are more likely to visit the dentist and seek preventive care, according to the 2017 Delta Dental Plans Association, Adult Oral Health and Well-being Survey. Routine dental exams can detect health problems early and lower the risk for costly conditions down the road like crowns, implants or even oral cancers. 

The rise of the gig economy could also change the way that dental benefits are sold to this population. For workers in the gig economy exclusively, individual dental plans with competitive coverage and pricing will become increasingly important. Many gig workers use apps like Lyft and Postmates to earn money, which may signal that they’re more likely to purchase insurance online and look for plans geared toward tech-savvy consumers. 

For more thought leadership from Delta Dental, subscribe to Insider Update, our newsletter for brokers, agents and consultants.

If you’re a benefits decision maker, administrator or HR professional, subscribe to our group newsletter, Word of Mouth.

Policy pops: Is there a role for dental in Association Health Plans?

3‑minute read

Join our guest blogger, Devin McBrayer, as she unpacks the Association Health Plan rule from the Department of Labor and its possible effects on the dental benefits industry. Devin is a Legislative and Policy Analyst based in Sacramento, California.

As you’ve probably heard, the Department of Labor (DOL) recently released the final rule regarding Association Health Plans. This rule makes it easier for small businesses to come together and form an “association health plan” (AHP). This allows businesses to leverage their combined bargaining power to purchase health benefits for their employees. Brokers will play an extremely important role in working with AHPs, especially newly-formed AHPs, which will likely have minimal experience working within the health benefits industry.

The new rule makes three major changes to the regulations concerning AHPs:

  1. AHPs can now form across geographic regions such as counties or states
  2. AHPs can consist of organizations from different industries as long as the organizations are within the same geographic region
  3. Self-employed individuals, for the first time ever, will be able to join an AHP

These changes were not as flexible as some organizations hoped. However, chambers of commerce in Nevada and Texas have already announced their intention to form AHPs to provide health benefits to their members, and we anticipate many more AHPs forming in the next several months.

Although the rule does not specifically mention dental benefits, it does state that AHPs can provide excepted benefits, such as dental or vision, to their members. AHPs that choose to obtain dental benefits for their members will likely want to take advantage of more flexible benefit designs, such as diagnostic-and-preventive-only plans.

Since AHPs are able to act as a large group, they do not have to follow certain ACA requirements such as meeting actuarial value standards or providing essential health benefits, which could bring down the cost of premiums. On the other hand, AHPs must continue to follow existing large group requirements such as providing preventive services without cost-sharing, guaranteed issue, or prohibitions on lifetime maximums.

The DOL rule states that new fully-insured AHPs are allowed to form starting September 1, 2018; existing self-insured AHPs are allowed to follow the new DOL rule starting January 1, 2019; and new self-insured AHPs will be allowed to form beginning April 1, 2019. However, some states already have laws on the books banning the formation of new AHPs, particularly laws that ban Multiple Employer Welfare Arrangements, which encompass AHPs. In addition, some states such as Vermont and Pennsylvania have taken steps to make it more difficult for AHPs to form in their states.

Time will tell whether AHPs will proliferate and there are still many questions that need to be answered as state insurance commissioners come to terms with this new rule. Brokers will be on the front lines and will likely be the first to hear about organizations that are interested in joining together to form an AHP. As always, the Public & Government Affairs team here at Delta Dental will be closely watching what happens next.

For more thought leadership from Delta Dental, subscribe to Insider Update, our newsletter for brokers, agents and consultants.

If you’re a benefits decision maker, administrator or HR professional, subscribe to our group newsletter, Word of Mouth.

Plain language policy: Spotlight on Public Affairs

Health care policy can be confusing. Really, really confusing.

That’s why we want to share periodic policy updates and insights with you — in plain terms. No jargon, no nonsense. To kick off our Plain Language Policy series, we’d like you to meet two of our key policy players, Stephanie Berry and Devin McBrayer.

Stephanie Berry and Devin McBrayer headshots


Tell us a little about yourself. Your educational background, past work experience, personal accomplishments, etc. 

Stephanie: I have worked at Delta Dental for five and a half years in government relations – primarily handling legislative analysis.

Before coming to Delta, I worked for California Primary Care Association (CPCA) for five years, representing clinics that mostly serve the uninsured and underserved. At CPCA, I was the Assistant Director of Federal Affairs, so I ensured everyone was educated on the Affordable Care Act and what that would mean for them. I really enjoyed doing that.

I started in advocacy and legislation working for Congresswoman Doris Matsui. I worked in her district office, doing a lot of healthcare outreach and that got my feet wet to move toward straight advocacy.

Devin: I also came from Doris Matsui’s office, which is how I met Stephanie. Before that, I worked in D.C. for Congresswoman Lois Capps on the Energy and Commerce Committee. I focused on health policy, assisting with health reform bills and analyzing them before coming to Sacramento.

I have a Master of Public Health (MPH) from George Washington, and being in D.C. was a great experience to see first-hand how legislation is made and how it goes through the regulatory process. So I know how to analyze things here when they come across the table.

Before we’re all work and no play, what do you like to do for fun? What are your hobbies or interests outside of work?

Stephanie: I’m an avid skier; my husband snowboards and the kids ski. Living in Sacramento, we’re close to Sierra Nevadas, so we get to play in the snow, but we don’t have to live in the snow. It’s nice!

Devin: I’m into biking. I live in a super small apartment downtown, but we have four bikes. I also love to hang out with my dog.

Okay, so getting down to business, what is your role at Delta Dental? 

Stephanie: We keep track of new legislation and regulations that affect our enterprise companies. Because our brand is in 15 states plus D.C., that’s where we spend most of our focus. We have lobbyists in each of these states. We write letters of support or opposition and take part in advocacy activities.

We’re also part of the National Association of Dental Plans (NADP) and America’s Health Insurance Plans (AHIP), which help us advocate on the issues happening in states where we don’t have as much presence.

In 2017, we tracked 750 bills. More than 5,000 bills come up in our search topics, and we narrow those down to those that might affect us. 150 of the 750 were signed into law; 50 of those affected us.

What is it like having a direct impact on health policy and legislation? 

Stephanie: It’s feeling like you can make a difference. You can work with constituents when working for a congresswoman. You see the impact. In this role at Delta Dental, it’s writing a support or opposition letter and seeing your advice taken into account.

Devin: Stephanie and I both really enjoy politics and the legislative process. It’s a hobby to be involved. Being active in the political process and analyzing legislation and regulations might seem intimidating to some people, but we enjoy digging through them. With our background, sometimes we are lucky in that we intuitively understand the way a bill may have been designed a certain way and why. We just think it’s fun!

It sounds like you get to have fun for a living. What jumps out as making your work worthwhile?

Stephanie: Coming to this job being raised in California, it’s so interesting learning how other states think. I enjoy going to the Capitol in other states and learning that different perspective. The fact that we have people with boots on the ground in all these states is so helpful. I even went to Montana this year, and partnered with Jim Dole (Sales Account Executive). He was so great at explaining how things tick there. I love learning the history. And I was in Atlanta advocating on a bill recently – that perspective keeps things interesting.

Since you’re new to Delta Dental, what are some of your first impressions? What do you like most about your job so far?

Devin: I most enjoy the team I work with; they understand my background. We’re all equally passionate about the work we’re doing and we all want to be as helpful as possible to other business units. My first few months here have really been about becoming a better resource to the rest of the company. So far I like the openness to collaborate and work together.

Part of our purpose as a dental benefits provider is to “enhance lives” — can you cite an example of something you’ve worked on where you truly think we’re achieving that purpose?

Stephanie: There was a piece of legislation enacted in California in 2015 — AB 648. We supported this bill, which was brought forth by consumer groups. It establishes virtual dental homes, which is kind of like telehealth. Dental providers and hygienists can work in low-income areas, schools, Head Start programs, and clinics and are able to do initial screening and send that info to a dentist somewhere else who can view the x‑rays to evaluate. It helps people where they are. We were the only dental plan in California to support this bill and it was signed into law.

This year, we also supported another California bill, SB 379. There was already a law that says all kids in California must see a dentist before first grade. This bill lets dentists host free oral health assessments at schools because many kids who aren’t do the screenings either don’t have insurance or they’re on Medicaid and don’t have time. This bill will make it easier for kids to have this assessment before first grade.

We’d agree that your role is definitely helping in our purpose to enhance lives. 

Let’s end on a fun note. Since you two work with such complex subject matter, how would you describe your job to an eight-year-old child? 

Stephanie: Gosh, okay. I would say that I’m working to make sure more people have the chance to see a dentist and be sure their teeth are clean and free from sugar bugs. I get to meet with a lot of people and talk about really important issues … I get to go around the country trying to make it easier for people to see the dentist. What do you think of that?

Perfect. Okay, and now a different question. If you had to create your own campaign slogan, what would it be?

Devin: I’ll go with my nickname from childhood and it was Devin from Heaven. I like to think that I’m very nice, and I’ve been successful in working in legislative offices because sometimes you have to deal with people who are… not so nice. So my campaign would definitely be centered around that. I’d come in on a cloud, and there would be lots of stars and some fun music!


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