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Benefits Business Good teeth—good health New dental products with rollover features provide marketing opportunity By Len Strazewski Lee Cameron is an insurance broker, not a dentist, but he worries about his clients’ dental health now more than ever before. New medical research links dental health to myriad other health issues, and a history of dental disease is now linked to heart disease, stroke and premature births, he notes. “I used to sell against dental benefits, focusing on the bigger benefits picture and broader health plans,” says Cameron, partner in Prime Benefits, an employee benefits specialty broker in Austin, Texas. The firm has 12 employees and serves 300 employer groups ranging from two to 500 employees. “But now it’s becoming clear that dental health is a big part of overall health, and dental benefits are becoming critical in the way we take care of ourselves,” Cameron observes. However, he says, the trend toward consumer-driven health plans may be moving employers away from providing separate dental insurance coverage—to the detriment of their employees’ health. “The health insurance trend is clearly moving toward the consumer-directed health model and that’s a good move overall,” he says. “I’ve had a medical savings account (MSA) and the new health savings account (HSA) since they became available.” But Cameron notes that even though employees covered by HSAs—or the sister plan design known as health reimbursement accounts (HRAs)—can use them to cover dental expenses, the participants may be reluctant to use their accounts to pay for preventive dental examinations and basic services. “Industry statistics show that if you don’t have a dental insurance plan, you are 40% more likely not to go to the dentist for preventive examinations,” he says. “And that may be putting you at risk—for dental disease and many other diseases.” As a result, Cameron has begun promoting a series of new dental insurance plans from Principal Financial Group that are designed to be compatible with consumer-directed health plans and promote dental health. The insurer began rolling out three new dental plans in April 2006 with benefits that range from payment for preventive examinations and treatments only, to broader basic dental services and access to a dental preferred provider network. Theresa McConeghey, dental product director at Principal, shares Cameron’s concern for the fate of dental health in the consumer-driven health plan environment. “While it is certainly true that dental care is a qualified expense applicable to HSAs, there is always a concern that participants may not be using their accounts to receive good preventive care and treatment,” she says. “And without appropriate education and dental information resources, they may not be aware of just how important good dental health is to a person’s total well-being.” McConeghey says that agents and brokers began asking her company last year for stand-alone dental insurance products that are compatible with the new consumer-driven health plans. “Dental products have always been consumer-driven because most encourage preventive procedures with minimal out-of-pocket expenses and cost-sharing for additional procedures,” she says. However, the new plans provide separate benefits that pay for preventive services and the basic dental services that can head off more expensive acute treatments and access to network discounts—before employees access their HSA funds. The plans give agents and brokers something new to introduce into their consumer-driven health plan discus-sions with clients, she says, and they give commercial clients more flexibility in encouraging health consumerism among employees without ignoring their dental health needs. Principal says the new plans can also be 40% to 65% less expensive than traditional dental health insurance, depending upon plan choice and group size. The company is also supporting its dental coverage with a comprehensive online Dental Center at http://www.principal.com. The education Web site features informa-tion on basic oral health, treatment plans and network providers. Plan participants can use the site to estimate dental treatment costs in their area and locate appropriate network providers. Cameron says the Principal plans are a good start toward motivating clients not to ignore dental health as a component of overall wellness. “Even the basic prevention package which doesn’t have a particularly big-dollar benefit is an important benefit. If everybody used the plan for preventive exams and treatments, we would go a long way towards good health. “And if we don’t take better care of ourselves … well … we’re just rearranging the deck chairs on the Titanic.” In 2004, Guardian Life Insurance Co. of America also introduced a new group dental insurance product with consumer-driven and managed care features. The Dental Maximum Rollover plan allows employee participants to roll over portions of their unused dental insurance maximum into a special rollover account, which can be applied, to future treatments that exceed the annual plan maximum. The plan encourages use of the company’s First Commonwealth Preferred Provider Network by allowing additional rollover for managed care participants. For example, employees with a dental benefit maximum of $1,000 can roll over up to $250 if they spend $500 or less during their plan year. If they use the PPO dentists, the rollover maximum jumps to $350. The rollover account limit for a $1,000 annual maximum plan is $1,000. Guardian offers dental plans with maximums ranging from $500 to $3,000 and rollover maximum accounts of $500 to $1,500. The insurer specializes in employers with five to 1,000 employees. Since the introduction of the Dental Maximum Rollover plan, the insurer has deposited more than $50 million in rollover maximum accounts, says John Foley, vice president of group dental. “This is really a value-added program for our plan participants,” Foley says. “Most dental plans are annual use-it-or-lose-it benefits. If you don’t spend your maximum, you lose it. But more than 70% of dental treatment is below a plan’s annual maximum, leaving a significant portion of benefits lost to the plan participant.” And when an expensive treatment is required due to dental emergency or cosmetic repair, participants must pay much more out-of-pocket. The rollover maximum plan allows participants to reserve against those future treatment needs, Foley says. The plan also provides a valuable marketing opportunity for agents and brokers, he adds. “Since the introduction of consumer-directed health plans, there has been a trend away from dental benefits as employers focus on establishing their health savings or health reimbursement accounts which can be used for dental expenses.” But the maximum rollover plan gives agents and brokers something new to introduce into benefits, he says. In March 2006, Guardian also introduced Vision Access, a free upgrade to its dental plans that offers network discounts on vision exams and materials for dental plan participants that are not already covered by a vision care benefit. The discount plan includes examinations, frames, lenses, contact lenses and laser surgery. “We found that many dental customers are lacking affordable vision care,” says Foley. * The author |
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