Broker blog from Delta Dental

Tag: group dental benefits (Page 1 of 4)

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.

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.

Making the move to Delta Dental: how onboarding works

When you’re helping your group clients select a dental benefits provider, there may be some hesitance to switch carriers. The different systems, migrating all the data, determining the benefits — it’s a lot of work. 

That’s why onboarding is so crucial. And Delta Dental has made sure that setting up a new client is as seamless an experience as possible.

When your client joins Delta Dental, an onboarding project manager and a team of experts oversee every aspect of the transition. They capture all the requirements and tasks needed to complete the move and get the system operating, including eligibility and billing and open enrollment.

“We listen to our clients’ needs,” said Account Executive Nora Colorado. “We know what questions to ask so we can design a benefits program that precisely meets their needs.”

The customer onboarding team is experienced in working with many different benefit enrollment systems. In transferring member data to our system, the onboarding team does a complete system validation once the group is set up. Onboarding staff work with the client, receiving numerous test files for review so that when it’s time to flip the switch, the member enrollment transitions flawlessly.

The onboarding project manager gives every client and stakeholder access to a dashboard that provides real-time insight into the timeline, tasks and updates to the onboarding process. Communication is essential in ensuring the success of every customer onboarding.

The process not only works, but it has earned rave reviews from clients who have joined Delta Dental. Last year, 98% of clients surveyed rated the onboard team and process as very good or excellent.

“We’ve done this many times and are comfortable with moving any client,” Colorado said. “Employees are pleased with the benefits they receive, but the move is so smooth they never notice any disruption in services.”

5 ways to help your group clients build a dental benefits package

In the midst of the Great Resignation, benefits are more important than ever for attracting and retaining employees. When you’re selling to groups, keep in mind that about 37% of employees would rather receive more substantial benefits than additional salaries or bonuses. To create a dental benefits package that stands out, consider these five plan enhancements for your group clients.

1. Lower the plan’s deductible for individuals and families

Lower deductibles are appealing to employees for a variety of reasons. They’re easier for employees to reach, meaning they’re more likely to have their plan pay for their dental treatments, and employees who frequently reach their deductibles are more likely to save. The same is true for family deductibles.

Delta Dental PPO™ plans generally do have deductibles or maximums, but they can be adjusted depending on your group’s wants and needs. Another option is DeltaCare® USA plans, which are particularly appealing for this reason — they don’t have deductibles or maximums.

2. Add a D&P waiver

With Delta Dental’s D&P Maximum Waiver® feature, the costs of covered diagnostic and preventive services (D&P) don’t accrue against a plan’s yearly maximum. Covered services typically include regular exams, x‑rays and cleanings.

Enrollees can then spend their coverage dollars on other needed dental services. D&P waivers are effective immediately, renew automatically and don’t require extra work from the employee or group to track remaining dollar amounts.

For more information, check out this flyer (PDF) or reach out to your local sales office.

3. Offer orthodontic coverage for all ages

The number of adults seeing orthodontists is at an all-time high, according to the American Association of Orthodontists, and that means the pool of prospective orthodontic patients is wider than it’s ever been.

Without coverage, prospective orthodontic patients can expect to pay between $3,000 and 6,000 dollars depending on their age. Delta Dental plans can help cut these costs in half. Orthodontic coverage is available under all DeltaCare USA group plans and can be optionally included in any Delta Dental PPO plan. Instead of limiting orthodontic benefits to dependents under 19, consider offering orthodontic benefits to children and adults.

4. Add implant coverage

The majority of adults ages 35 to 44 have lost at least one permanent tooth, and by age 74 more than a quarter of adults have lost all their permanent teeth.

One treatment for a lost tooth is an implant. Implants are an appealing option because they closely resemble real teeth, they’re permanent and comfortable, and they slow down the bone loss caused by losing a tooth. However, they can be expensive for patients without coverage. A single implant can cost up to $3,000 to $5,000.

Delta Dental offers several different options for implant coverage for groups. Implant coverage is available under Delta Dental PPO and some DeltaCare USA group plans.

5. Provide expanded coverage for chronic conditions

Serious health issues like heart disease, diabetes and HIV/AIDS affect millions of Americans each year, and people with these conditions are more likely to have oral health related problems as a result. With SmileWay® Wellness Benefits, you can add expanded coverage for enrollees with chronic illnesses and make your plan more attractive.

When your group clients choose to make this benefit available, their enrollees who have been diagnosed with diabetes, heart disease, HIV/AIDS, rheumatoid arthritis or stroke can receive 100% coverage for additional cleanings and gum treatment.

This optional benefit is available only for Delta Dental PPO plans, and eligible enrollees must opt in to receive the additional coverage. These benefits can help keep your groups’ employees smiling and healthy, and healthy workers are a win-win for their companies!


Having a competitive benefits package is key to recruiting and retaining valuable employees in a labor market that is replete with resignations. When you’re building benefits packages, adding coverage can enhance to your groups’ offerings and make those employers more attractive to prospective employees.

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