Articles
Dental Benefits Buck Health Care Trend
School Districts Give Delta Dental Top
Marks Year After Year
Changes Announced to DeltaCare Plan
Dental Networks for All Delta Dental Programs
Continue to Grow
2003 Annual Report Published
See How We've Grown in 35 Years
Delta Dental Revises EOB
Online Consultant News Available Free to Brokers
Cient Reminder Regarding Bill Payments
The average annual increase in the cost of dental
premiums has stabilized since 2001, as premium increases
for medical benefits remain well above 2001 levels.
Dental never saw the double-digit volatility that
keeps medical costs in the news. But while medical
increases remain at rates high above the original
2001 spike, dental has cut across the trend and climbed
down over the same period, according to new industry
analysis.
Employers, who cite pricing stability as among dental's
most attractive attributes, might find it easier
to continue spending on the popular benefit, which
has long been ranked by employees as their second
favorite next to medical.
"If you can decrease pricing pressure in the benefits
package when soaring medical costs are squeezing
other benefits, it's bound to be welcome news," said
Tom Dolatowski, vice-president of marketing for Delta
Dental Plans Association.
A recent market report from Mercer, a health care
consultancy, indicates that the average dental-benefit
cost will increase by about 6.8% in 2004, compared
with an increase of 7.6% in 2001. Annual increases
in fee-for-service dental plans and preferred-provider
organizations (PPOs) have been declining since 2001.
Most people are covered by these two plan designs.
But costs in dental health maintenance organizations
(DHMOs), which provide the highest degree of managed
care among dental plans, have risen slightly since
2002, according to the report.
A different report, from the National Association
of Dental Plans, gives more detail on what benefits
sponsors and subscribers can expect. For example,
fee-for-service family coverage from a medium-size
employer will cost about $5.75 more per month, compared
with last year.
"Dental pricing remains stable because the benefit
is designed to drive preventive care. When you prevent
or minimize disease, you minimize the need for expensive
remedial or restorative treatments," Dolatowski said.
Delta Dental Plan of New Jersey welcomed West Milford
Public Schools in West Milford, New Jersey, as one
of our first groups almost 35 years ago. School Superintendent
Robert Gilmartin recently told us why the district
has stayed with Delta Dental all these years.
"Whenever we looked around, we came to a collective
decision that Delta Dental provides the best options
and the best program for us," he says. "There has
never been a major issue with the contract, service
or implementation over the years."
The program meets the needs of the district's employees,
as well. "I don't think I've ever heard of anybody
going to a dentist who does not participate with
the program," says Gilmartin. "Most participating
dentists file their claims for them, so it saves
patients a lot of effort and energy."
Gilmartin has been with the school district nearly
30 years, and appreciates the Delta Dental benefit
on a personal level. "It's been a nice benefit, especially
as a parent. Service is an important piece of satisfaction
with the program. From my own personal experience,
I'd give Delta Dental high marks in customer service."
He adds that in the region's dental benefits market, "Delta
Dental is at the front of the parade."
Two things keep the Keyport, New Jersey, Board of
Education with Delta Dental Plan of New Jersey: "Consistent
employee and employer satisfaction," says Sally Gadomski,
who administers benefits for the district.
"We have a large provider population in Monmouth
County," says Gadomski. "Most dentists in the area
participate. There are no claim forms to handle.
Delta Dental has toll-free numbers to address patient
questions. Predetermination is good-if you have a
lot of work done, you know what your out-of-pocket
expenses are going to be."
Gadomski's supervisor, JoAnn Podracky, agrees. "You
know right up front what you're going to pay. There
are no hidden costs for patients."
Podracky also appreciates how efficiently Delta Dental
handles coordination of benefits. "We have a lot
of husband-and-wife teacher teams, who are both covered
by Delta Dental Plan of New Jersey. The coordination
of benefits is flawless."
The district reviews its dental benefits program
every year or so. "Whenever we review our plan, Delta
Dental keeps coming up on top," says Podracky. "The
fact that employees are happy makes it good for us.
There's a lot of satisfaction with the program."
Flagship Dental Plans has enhanced the local DeltaCare
plan design in response to subscriber and dentist
feedback. DeltaCare is a managed care dental HMO-type
program administered by Flagship, a wholly owned
subsidiary of Delta Dental Plan of New Jersey, Inc.
The enhanced plan covers additional dental procedures.
The copayments have also been updated to reflect
additional component costs of providing dental services,
such as dental materials and laboratory costs.
Benefit Enhancements
The following enhancements represent major additions
to covered services. These enhancements become effective
on the renewal date of each group's contract, subject
to the plan limitations and any applicable patient
copayment listed in the Schedule of Dental Benefits
and Copayments:
- Dental exams and x-rays performed by a specialist
(endodontist, periodontist, or oral surgeon)
- Bacteriologic studies for the determination of
pathologic agents
- Dental sealants - per tooth
- Resin based posterior composite filling - one
surface
- Resin based posterior composite filling - two
surfaces
- Resin based posterior composite filling - three
surfaces
- Resin based posterior composite filling - four
or more surfaces
- Core buildup including any pins
- Pin retention per tooth in addition to restorations
- Cast post and core in addition to crown (individual
crowns and fixed prosthetics)
- Each additional cast post, same tooth (individual
crowns and fixed prosthetics)
- Prefabricated post and core in addition to crown
(individual crowns and fixed prosthetics)
- Each additional fabricated post - same cost (individual
crowns and fixed prosthetics)
- Full mouth debridement to enable comprehensive
evaluation
- Emergency care allowance increased from $50 to
$100
Changes to Patient Copayments
Patient copayments for dental procedures requiring
cost sharing have been increased to reflect the
trends in dental treatment costs. This enables
Flagship to maintain competitive premiums, offer
comprehensive, high value plan designs with copayments
at significant discounts from average dental charges,
and continue to attract and retain participating
dentists who meet Flagship's extensive credentialing
and facility evaluation requirements.
Copayments were not added to procedures that required
no patient copayment under the current plan design.
Detailed Plan Comparison
Employers will receive a complete comparison of their
current plan design and the new, replacement plan.
In addition, they will receive a supply of updated
benefit booklets to distribute to those employees
covered by the Flagship-DeltaCare program.
If you have any questions, please feel free to contact
your account executive.
Across the nation, three out of four licensed dentists
participate with Delta Dental, and the number of
participating dentists continues to grow. Here's
a brief snapshot of our dental benefits programs,
and how they could benefit your clients.
DeltaPremier Program
This program's network added 551 dentist locations
in New Jersey and 323 dentist locations in Connecticut
since 2002. This is a growth rate of 9% in New Jersey
and more than 15% in Connecticut. The DeltaPremier
program features our most extensive network. It also
offers employers the best in managed care and cost
containment services. Three out of four licensed
dentists nationwide participate. There are currently
6,473 participating DeltaPremier dentist locations
in New Jersey, 2,493 participating dentist locations
in Connecticut, and 142,000 nationwide.
Delta's Advantage Program
This program is a popular option for groups whose
members are located only in New Jersey. Delta's Advantage
Program offers access to cost-efficient dental care
provided on a fee-for-service basis, and a large
network of participating dentists. It allows complete
freedom of choice in dentist selection. Delta's Advantage
Program network has grown 19% since 2002. There are
4,105 participating dentist locations in New Jersey.
DeltaPreferred Option Program
This is our fastest growing program. It allows employers
to increase the value of dental benefits to employees,
while decreasing their overall dental plan costs.
The DeltaPreferred Option program costs employers
about 20% less than the DeltaPremier plan. This is
a popular addition to many employers' "cafeteria" (or
flexible) benefits plans. The DeltaPreferred Option
network grew 25% since 2002 in New Jersey and nearly
23% in Connecticut. Its network has more than doubled
in size over the past five years. It has 3,387 participating
dentist locations in New Jersey, 1,136 participating
dentist locations in Connecticut, and 67,000 participating
dentist locations nationwide.
DeltaPreferred Option Point of Service Program
This program offers subscribers access to both DeltaPremier
and DeltaPreferred Option dentists, providing different
benefit levels for each network. It gives subscribers
greater flexibility in selecting the dentists and
benefit levels that meet each family member's needs.
DeltaCare Program
Our dental HMO program is administered by Flagship
Dental Plans, a subsidiary of Delta Dental Plan of
New Jersey, Inc. Employees choose a primary care
dentist, who coordinates all necessary covered dental
care and referrals to network specialists.
A word about our networks
Delta Dental regularly credentials its participating
dentists to help ensure that they continue to meet
our standards. Our dental network coordinators meet
regularly with participating dentists to ensure that
they remain satisfied with Delta Dental. Our dental
network coordinators also recruit nonparticipating
dentists into our network.
Our large dental network and ongoing growth are two
reasons why many clients select Delta Dental Plan
of New Jersey as their dental benefits provider.
Employees can often keep their same dentists when
their employers switch to Delta Dental. Most subscribers
can easily find a participating dentist near their
home or workplace.
In our 2003 Customer Satisfaction Survey, conducted
by Brownstone Information Resources, subscribers
expressed overwhelming satisfaction with the size
of Delta Dental's network, the quality of care they
receive from participating dentists, and their dental
benefits program overall.
For more information about our dental benefits programs,
please visit our Web site at www.deltadentalnj.com
and click "Products" on the navigation bar on the
left. Information about DeltaCare products is available
by clicking "Flagship" on the navigation bar.
Delta Dental's 2003 Annual Report - Touching Your
Life Every Day - is now available. The report features
photographs of the everyday people who are our subscribers
and perform services for our community - a bus driver,
health care worker, police officer, and many others
who are among the more than 1.5 million people covered
by Delta Dental Plan of New Jersey, Inc. in 2003.
The 2003 Annual Report features:
- Performance highlights, including our
96% customer retention rate, and high customer
satisfaction levels as measured by our annual benefits
manager and subscriber surveys.
- Financial highlights, including our subscription
income growth to $443.4 million.
- Philanthropic highlights, including our
Foundation's support of causes such as Special
Olympics New Jersey, numerous children's health
and welfare organizations, dental scholarships
and oral-health research.
To order your copy of the 2003 Annual Report, visit
our Web site at www.deltadentalnj.com, click "Our
Company" on the left navigation bar, then "Annual
Report." Complete the order form online. The Annual
Report will be mailed to you.
A lot of milestones happened in 1969. Neil Armstrong
walked on the moon, the Beatles performed their last
concert, and ARAPANET (the predecessor of the Internet)
was created.
That was also the year that Delta Dental Plan of
New Jersey began fulfilling its mission "to promote
oral health to the greatest number of people by providing
accessible dental benefit programs of the highest
quality, service, and value." On July 8, 1969, the
New Jersey Dental Service Plan (our original name)
filed the articles of incorporation with the New
Jersey Secretary of State.
Here's a snapshot of how far we've come:
First headquarters (1970)
A room of Dr. Joseph Pollack's dental office in East
Orange, New Jersey
Current headquarters (2004)
Nearly 90,000 square feet at 1639 Route 10, Parsippany,
New Jersey
Number of groups:
August 1972: 16
December 2003: 2,200
First claim paid: January 1971, to Dr. Stanley M. Schlossman of Morris
Plains, New Jersey
Claims processed in 2003: More than 2.8 million
Participating New Jersey dentist locations:
1970: 2,200
2003: More than 6,000
Number of subscribers:
January 1971: 4,000 subscribers and dependents
December 2003: More than 1.5 million subscribers and dependents
Claims milestones:
1974: More than $1 million in benefits paid
2003: $388.1 million in benefits paid
Thank you for helping us to come so far. We look
forward to continuing our growth and our relationship
with you in the years to come!
Delta Dental has recently revised its Explanation
of Benefits (EOB) form. The term "allowed amount" has
been replaced with "Amount Used for Benefit Calculation." Our
intention is to provide greater clarity. In addition,
both the "approved amount" and "Amount Used for Benefit
Calculation" are defined in the EOB so dentists and
subscribers have a clear understanding of those terms.
Approved amount is "The total amount which
the dentist is permitted to collect as payment
in full for the specified service. It includes
the dental benefit plan's payment as well as the
patient's deductible and/or copay."
Amount Used for Benefit Calculation is "The
fee amount that the dental benefit plan provides
for use in calculating the dental benefit plan
payment for the specified service. The dental benefit
plan payment may be less than this fee amount due
to patient deductible, copay, plan limitations
or exclusions."
Have you registered to receive Consultant News?
Delta Dental's online Consultant News is published
every other month for brokers and consultants. Each
bimonthly issue contains information about dental
benefits, and Delta Dental's products and services.
Consultant News is not a rehashing of stories that
appear in Broker News, which comes out quarterly.
Instead, Broker News and Consultant News complement
each other, with their own content and approach.
A subscription to Consultant News is available to
any broker or consultant who requests it. Subscriptions
are free. Headlines are sent to your e-mail inbox
every other month. Just click the link to read the
full story. To subscribe, go to www.deltadentalnj.com,
click "Brokers" and enter your e-mail address in
the "Consultant News" subscription box.
You may unsubscribe to Consultant News at any time.
Please note that we do not share our subscription
list, and you will not receive spam as a result of
subscribing to Consultant News.
Lately, some groups are forgetting to include the
remittance page when they pay their monthly bills.
The remittance page is essential because it tells
us which account should be credited with the payment.
It is especially critical when several sublocations
pay their own bills.
We want to be sure to credit each payment correctly.
Please help us by kindly reminding clients to include
the remittance page with their payments. This helps
ensure that their payments are posted correctly.
It will also help save them the inconvenience caused
by payments being credited to the wrong account. |
