Broker blog from Delta Dental

Tag: D&P utilization

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.

Help your self-insured groups promote preventive care

Making full use of diagnostic and preventive services is one of the best things your group clients can do to stay healthy and save money. Regular trips to the dentist can help catch little problems before they become big ones. That means members can avoid potentially costly and painful dental problems and groups can save money and avoid lost productivity, all by increasing D&P utilization.

Enter the preventive care reminder emails

Help your self-insured group clients promote D&P utilization with an opt-in email series. This email campaign, available for self-insured groups, targets members who haven’t generated any dental claims in the past seven months. As part of this campaign, members will receive a series of three emails:

  1. An email reminding them to schedule an appoint for a cleaning and exam.
  2. A congratulatory email after their visit applauding them for taking charge of their oral health. This email will also encourage them to set a reminder to return to the dentist in six months.
  3. A reminder email to schedule another exam and cleaning (if they chose to set one).

Does this email series really work?

By comparing claims data across different groups, we’ve found a substantial increase in preventive care utilization rates among employees who receive and open preventive care reminder emails.

Higher D&P utilization means healthier smiles for members, more savings for group clients and another perk you can use to make selling Delta Dental even easier. That’s what we call win-win-win.

Are you interested in the preventive care reminder campaign for your self-insured group clients? Contact your Account Executive!

All you need to know about utilization metrics, you learned in kindergarten

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.

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