Tag Archives: Delta Dental

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ACA and Dental Insurance: 5 Things to Think About

While much of the attention on the implementation of the Affordable Care Act has focused on medical coverage, Arizona residents are also able to purchase dental insurance through the Federally Facilitated Marketplace (FFM) beginning on Oct. 1, 2013, through March 31, 2014.

Delta Dental of Arizona states, “We are especially pleased that the new law recognizes the special value of stand – alone dental plans. Under the terms of the law, those who seek coverage through the Federal insurance exchange will be able to purchase separate coverage from dental carriers, like Delta Dental, that have a track record of providing services in the most cost-effective, consumer-friendly manner.”

The Federally Facilitated Marketplace can be found at www.Healthcare.gov and is particularly important for Arizona residents who do not have access to coverage either through their employers, on their own, or who aren’t covered by Medicaid. The new health care law requires that most U.S. citizens and legal residents have health insurance or pay a penalty. People are not required to purchase health and dental insurance through the exchange; they can go directly to a benefits carrier. However, if they might qualify for federal tax subsidy to lower their premiums the FFM is the place to go. Members can begin enrolling as of October 1 with coverage beginning Jan. 1, 2014.
Delta Dental of Arizona offers the following information to help you understand how the Affordable Care Act has changed dental benefits and to select a dental plan that best fits your needs.
1. Not All Networks on the Exchange are Created Equal
Dental benefits are provided through an arrangement with local dentists. Dental carriers enter into contract with the dentist, who in turn agrees to charge a certain price. The key to a great network is how your plan contracts with dentists to get you the lowest cost and highest quality of care. Delta Dental of Arizona negotiates a low cost with our statewide network of more than 3,100 dentists, and we protect members from balance-billing (the difference between what the plan pays and what the dentist charges). Lower out-of-pocket costs mean that the annual dental benefits stretch further.

But not all networks are created equal. Some dental carriers offer a small discount from the standard dental office fee. This practice can shift the burden of expense to the patient for costly services such as root canals and crowns. And the discounts offered may apply to only a very narrow network of dentists. This means the range will be smaller than a larger, robust network. Make sure dental insurance offers the lowest cost…with the most choice.

2. Do the Math
Be sure to understand what payments you are responsible for. In addition to the monthly premiums, there may be cost-sharing arrangements on services. Look for a plan that encourages preventive care by covering 100% of the costs of exams, cleanings, x-rays, sealants and fluoride treatments. Secondly, look at deductibles – the amount that must paid before the insurance company pays for all or a portion of the costs. Deductibles vary across plans. Lower monthly payment plans will typically have a higher deductible. In addition, there are also out-of-pocket maximums, which mean that once the out-of-pocket maximum has been paid, the insurance plan pays 100%.

Keep in mind; if you are purchasing your dental benefits through a medical insurance carrier on the new online insurance marketplace, you need to look carefully at how deductibles and out-of-pocket maximums apply. For example, a deductible for a health plan might be $2,000 compared to a typical deductible for a stand-alone dental plan that ranges from $25 to $100. This means you could pay for a lot of dental costs before the medical plan starts paying 100%. That can be costly for the average family.

3. An Ounce of Prevention
When choosing a dental plan, it is important to review what services the plan covers. While it may seem like all plans are the same, many vary in coverage. Look for an insurance plan that emphasizes preventive and diagnostic care. Many people don’t realize that costly and painful dental problems can be prevented by regular visits to the dentist…even at the earliest of ages. The American Dental Association recommends that children see a dentist by age 1. Dental problems such as cavities are nearly 100% preventable.

4. Getting the Most Value
Every family has a unique situation. It is important to assess dental plans based on your family’s needs. Do you have children who are ready for braces? Might you be heading for a crown or root canal? Are implants or dentures in your future? Or are annual exams, cleanings and X-rays the extent of your dental needs? Make sure you are paying for services you need and getting the best value on those services. It’s not just about cost; it’s about coverage as well. Look for the coverage that works best for you and your family.

5. Who Are You Doing Business With?
You are sure to come across many companies in the online marketplace. Some are big, but many will be small, new businesses. It is important to make sure you’re working with an established company. Review their company profile and make your decision based on the answers to several questions. How long have they been in business? How many years have they been specializing in dental insurance? Are they local or national? There has been a lot of consolidation in the insurance industry. How much experience your dental insurance company has processing and paying dental claims is important. You don’t want to get a notice from another company you are not familiar with that has subcontracted with your insurance company because that means dental insurance is not your insurance company’s main area of expertise. Established dental carriers have the benefit of smooth, accurate operating procedures.

Delta Dental of Arizona is a Qualified Health Plan issuer in the Federally Facilitated Marketplace. For questions about buying insurance on the Arizona Health Insurance Marketplace, visit www.HealthCare.gov in English or www.CuidadoDeSalud.gov for Spanish, or call (800) 318-2596. For questions about Delta Dental of Arizona plans, visit www.DeltaDentalCoversMe.com, call toll-free at:  800-352-6132, Monday through Friday (CT) or via email at customerservice@deltadentalaz.com.

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Delta Dental launches new mobile app

Delta Dental is proud to announce its new mobile application available for mobile devices using iOS (Apple) or Android. Launched two weeks ago, the app has over 1,000 downloads to date.

With this new, free mobile app, subscribers can search for a dentist, view claims and coverage details and access their ID cards right from their phone. Through a secure login process, subscribers will always have access to their oral care history, benefits coverage and can even email their mobile ID card to their dentist before an appointment.

A fun feature of the app is a toothbrush timer set to music for the recommended two minutes of brushing.

“We are excited to offer our subscribers easy access to their dental coverage through the app,” said Jay Kolker, vice president of operations and information technology for Delta Dental of Arizona. “Even those that aren’t Delta Dental subscribers can access the toothbrush timer and dentist search, so it really is an app for everyone.”

To download the app, visit the Apple App Store or the Google Play Store.

AB's Top Lawyer's List, AZ Business Magazine Mar/Apr 2011

Delta Dental names Director of Legal Affairs

Delta Dental of Arizona is pleased to announce the hiring of Anne Bishop as the dental insurance company’s Director of Legal Affairs and Compliance.

“We are thrilled to welcome Anne to the Delta Dental team,” said Allan Allford, CEO for Delta Dental of Arizona. “Her expertise in health care law will be an asset as we prepare for the launch of private dental exchanges and other aspects of the Affordable Care Act.”

A magna cum laude graduate of Arizona State University’s Sandra Day O’Connor College of Law, she has extensive commercial and healthcare litigation experience. Prior to joining Delta Dental, Bishop served as an associate attorney for Snell & Wilmer L.L.P. in Phoenix, where she focused on health care services, health care transactions, compliance and regulatory matters.

Bishop’s expertise includes seven years of experience analyzing and researching legal issues in healthcare, advising clients on HIPAA and other healthcare compliance issues, and coordinating intra-company fraud investigations. In addition, Bishop spent nearly 14 years with the National Security Agency, where she received more than a dozen awards for outstanding performance and exceptional contributions to the intelligence community. Bishop also holds a bachelor of arts in international relations from the University of Pennsylvania.

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7 Tips for Choosing a Dental Plan for Small Businesses

Graduating students and alumni rate dental coverage among the top five most important benefits — medical insurance, yearly salary increase, 401(k) retirement plan, dental insurance and life insurance. In an increasingly competitive environment, a strong benefits package can play a key role in attracting and retaining top talent. Dental coverage has an important position in rounding out that package.

Unfortunately, many small business owners are unsure what to look for when choosing a dental benefits plan. In fact, 90 percent of benefits decision-makers rely on a broker or consultant to help them choose the best plan and carrier for their employees.

Here are seven tips from Delta Dental of Arizona to help you choose the best dental insurance plan for your company:

1. Understand your employees’ needs
Understanding your organization’s oral health needs is the first step in evaluating your dental benefits options. Different demographics face different oral health challenges. For example:
• Employees ages 20-39: This generation generally faces fewer oral health challenges. They benefit most from prevention and find value in a plan that covers basic cleanings and checkups. Members of this age group are more likely to be starting families.
• Employees ages 40-59: Members of this group often require restorative procedures. As their oral health needs change with age, they tend to seek ways to manage their health and wellness. They value a benefits carrier that provides access to expert resources and offers them choices to help confront oral health challenges.
• Employees ages 60+: Employees nearing retirement are more likely to face chronic conditions. They value a plan that helps them manage the expenses associated with more complicated procedures.

2. Find out how big the dentist network is
Employees are likely to be more satisfied with their dental plan when they can answer “yes” to this question: “Is my dentist in the network?” Having more in-network dentists to choose from improves network utilization rates simply because more employees are visiting an in-network dentist. This means more enrollees are enjoying protection from balance billing and saving the group money on claims – a satisfying result for the employer and employees.

3. Focus on preventative care
A strong dental insurance company will help employees manage their oral health by encouraging preventive care. This reduces long-term costs on the dental side and could also have a significant long-term impact on overall health and health care costs.

4. Ensure benefits information is available online
Progressive dental carriers’ online capabilities enhance customer service, provide flexibility and transparency and improve operating efficiency, from billing and paying claims to enrollment and enrollee communication.

5. Ask about customer satisfaction levels
An employer and its employees must have confidence that they’ll be taken care of after signing on with a carrier. Some carriers even include guarantees with financial penalties should they fail to meet agreed-upon service standards.

6. Consider adding enhanced benefits coverage
The U.S. Surgeon General’s office has noted correlations between periodontal disease and health care costs for certain medical conditions, and studies examining the effects of oral health on systemic medical conditions continue to point out even more potential connections.

For little or no increase in premium, many carriers can add enhanced benefits for individuals with medical conditions that may benefit from additional oral health care. This could include pregnant women and/or persons with diabetes, cardiac conditions, suppressed immune systems, risk of oral cancer and other systemic diseases.

7. Be picky
Medical and dental benefits operate under very different models. While the former focuses more on treatment, the latter concentrates primarily on prevention. Furthermore, building and maintaining an effective dentist network is much different than building a network of medical care providers.

All things equal, an employer should choose a dental carrier that’s an expert at providing and delivering effective, high-quality dental benefits. A carrier committed to providing such dental benefits will be intimately familiar with the latest dental research, will have aggregated data on dental utilization and dentist reimbursements, and will be able use that data to create better products and control costs.

Regardless of the dental benefits carrier they choose, employers should be commended for the decision to provide dental benefits to their employees. People with dental benefits exhibit more healthy behaviors and better oral health habits – including brushing, flossing and visiting the dentist more regularly – and are less likely to smoke.

David Hurley is the vice president of sales for Delta Dental of Arizona, the leading dental benefits provider in Arizona, serving more than 753,000 enrollees and more than 3,100 contracted dentists across the state.