Dental Insurance
- Thread starter djbfunone
- Start date
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- group dental
- 7,790
So if the dentist is past age 84 they won't pay the claims? I think that's a little close minded. I have a physician client that's 80 and still delivering babies.
- 7,790
Over a week ago I received an email touting what appears to be a pretty decent dental plan for Individuals, Seniors, or Groups of 2 or more, including voluntary Dental and Vision. The highlights mentioned are:
NO networks - 90% U&C- choose wown dentist
NO participation requirements for voluntary dental down to
2
NO waiting periods---even for Major or Ortho services
THREE covered cleanings per year
A $2,000 annual maximum
When I tried to downlaod the brochure, I received an error message stating "Proxy Error" so emailed a reply for more information. Still haven't received a reply. The sender is [email protected] of Henderson, NV. It sounds almost too good to be true. Is it possibly Spam?
I am sure that some of you other guys/gals must ahve received this email. Any information on them?
NO networks - 90% U&C- choose wown dentist
NO participation requirements for voluntary dental down to
2
NO waiting periods---even for Major or Ortho services
THREE covered cleanings per year
A $2,000 annual maximum
When I tried to downlaod the brochure, I received an error message stating "Proxy Error" so emailed a reply for more information. Still haven't received a reply. The sender is [email protected] of Henderson, NV. It sounds almost too good to be true. Is it possibly Spam?
I am sure that some of you other guys/gals must ahve received this email. Any information on them?
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B
Briefcaseboy
Guest
For dental, vision and hearing insurance, place buisness card holders with cards in them at dentist offices, vision care centers, hearing aid centers, should get plenty of calls, I would think.
- 624
Check to see if there are any waiting periods... sometimes it can be 6 months or 12 months.
- 4,707
You actually want these people to call you? No Thanks. I spend my time on more profitable lines of health ins.
The dental market is a cash only type market. Dental "insurance" typically pays only $1000, after 1 year waiting period. That's NOT insurance, that's 1 crown/root canal. "Insurance" is structured as a prepay preventative care plan. I found dental insurance to be a waste of time, and not enough comp. Most people won't change dentists, and their dentist is rarely on the plan you recommend, unless you go to a chop shop. I found dental discount plans to be the best solution (paired with an HSA health plan - tax deduct discounted prices). You won't have any unhappy clients on a cheap discount plan. If they get cleanings, and have any additional work done, they will save more money than the cost of the plan, not lose money. I've also found the dentist is in competition with us selling their own discount plans right in the office. In fact, of the dozen discount plan I sell, while I wanted to buy through myself, even factoring in the commission, the dentists' own discount plan was better than anything I sell.
In the 31 years I've been in this industry, marketers have come up with new ideas for individual/family dental, but when the dust settles, nothing has changed. Here's the history on individual/family dental:
INDEMNITY OR PPO - They are more expensive, have low annual benefit maximums ($1000 to $1500 usually), and have long waiting periods for major services (and sometimes even for basic services). Of course, this is necessary to avoid adverse selection, early utilization followed by early termination. The problems are that the member could fund their own dental care with the amount of premiums + deductible & co-insurance. Another problem is that the insurance company tends to spike the premium rate (or cancel the entire program) after the waiting periods are over. The only time this really can mathematically benefit the client is when the client has a large number of children, and they all get their preventive work for free, plus some basic & major services.
PREPAID DENTAL, DENTAL HMO, DENTAL DISCOUNT PLAN - very inexpensive premium (usually paid annually at about $100 for a single or $200 for a family). No waiting periods. Unlimited benefits. You pay specific copays for each listed service. When you calculate it out, it comes out to practically 100% for Preventive, 80% for Basic and 50% for Major - very similar to the co-insurance structure of an indemnity plan. Sometimes certain specialists in an area get together and refuse to sign up on these lists (like Endodontists who do root canals for instance), so that can cause a problem. There are a bzillion of these plans. I hate these plans. I get too many complaints. But if a client insists on it, I just give them my broker link at dentalplans.com. I tell them to ask their dentist which plan he works with, and then just sign up for that plan. Problems with these plans are --- It's an HMO style restricted network. The Dentists tend to come and go, because they use these discount plans to build a practice, then they drop the plans. Established dentists usually don't sign up on the network, and actually hate these plans. Dentists get paid very little from the premium (actually, it's a fee not a premium because this isn't actually insurance). The portion of the "fee" that they get is so low that they must gather it for several months before they can justify seeing the member for their initial exam, xrays, cleanings (which is usually free to the member). For that reason, many times the member calls for an appointment and is told the next available appointment is 9 months away. Sometimes the member gets dinged for quite a number of services for additional copays. Sometimes the member gets a little less quality materials in their mouth. I'm not saying all Dentists do this, but some do. You can't blame the dentist for this - the discount plan is quite a deep discount.
GROUP INSURANCE - this is true insurance. The other ones listed above really aren't - they are just another way to budget for costs. Some small businesses try to avoid the individual/family dental problems by buying it as a business group. However, most dental insurers won't insure very small businesses or family controlled businesses. In other cases, group dental insurance can be a very fine product to offer.
DELTA DENTAL - here in AZ, if you call a dentist and ask which plan they take, the first answer you get is Delta Dental!!! Just recently Delta Dental of AZ came out with their own individual dental plan. It's not bad. It has all the issues I mentioned in the first paragraph above about indemnity/ppo plans. But in this case, they are probably a stayer. Delta very rarely enters a market unless they know they can succeed, and the chances that they will discontinue the program after the waiting period is over is slight. (BTW, Delta waives the waiting period for current Delta members who don't have a lapse in coverage when they transition from group to individual). I'm not promoting Delta, btw (I have no stake in it), just saying they might be a stayer when other indemnity/ppo insurers tend to withdraw from the market or spike renewal premiums after waiting periods are over.
INDEMNITY OR PPO - They are more expensive, have low annual benefit maximums ($1000 to $1500 usually), and have long waiting periods for major services (and sometimes even for basic services). Of course, this is necessary to avoid adverse selection, early utilization followed by early termination. The problems are that the member could fund their own dental care with the amount of premiums + deductible & co-insurance. Another problem is that the insurance company tends to spike the premium rate (or cancel the entire program) after the waiting periods are over. The only time this really can mathematically benefit the client is when the client has a large number of children, and they all get their preventive work for free, plus some basic & major services.
PREPAID DENTAL, DENTAL HMO, DENTAL DISCOUNT PLAN - very inexpensive premium (usually paid annually at about $100 for a single or $200 for a family). No waiting periods. Unlimited benefits. You pay specific copays for each listed service. When you calculate it out, it comes out to practically 100% for Preventive, 80% for Basic and 50% for Major - very similar to the co-insurance structure of an indemnity plan. Sometimes certain specialists in an area get together and refuse to sign up on these lists (like Endodontists who do root canals for instance), so that can cause a problem. There are a bzillion of these plans. I hate these plans. I get too many complaints. But if a client insists on it, I just give them my broker link at dentalplans.com. I tell them to ask their dentist which plan he works with, and then just sign up for that plan. Problems with these plans are --- It's an HMO style restricted network. The Dentists tend to come and go, because they use these discount plans to build a practice, then they drop the plans. Established dentists usually don't sign up on the network, and actually hate these plans. Dentists get paid very little from the premium (actually, it's a fee not a premium because this isn't actually insurance). The portion of the "fee" that they get is so low that they must gather it for several months before they can justify seeing the member for their initial exam, xrays, cleanings (which is usually free to the member). For that reason, many times the member calls for an appointment and is told the next available appointment is 9 months away. Sometimes the member gets dinged for quite a number of services for additional copays. Sometimes the member gets a little less quality materials in their mouth. I'm not saying all Dentists do this, but some do. You can't blame the dentist for this - the discount plan is quite a deep discount.
GROUP INSURANCE - this is true insurance. The other ones listed above really aren't - they are just another way to budget for costs. Some small businesses try to avoid the individual/family dental problems by buying it as a business group. However, most dental insurers won't insure very small businesses or family controlled businesses. In other cases, group dental insurance can be a very fine product to offer.
DELTA DENTAL - here in AZ, if you call a dentist and ask which plan they take, the first answer you get is Delta Dental!!! Just recently Delta Dental of AZ came out with their own individual dental plan. It's not bad. It has all the issues I mentioned in the first paragraph above about indemnity/ppo plans. But in this case, they are probably a stayer. Delta very rarely enters a market unless they know they can succeed, and the chances that they will discontinue the program after the waiting period is over is slight. (BTW, Delta waives the waiting period for current Delta members who don't have a lapse in coverage when they transition from group to individual). I'm not promoting Delta, btw (I have no stake in it), just saying they might be a stayer when other indemnity/ppo insurers tend to withdraw from the market or spike renewal premiums after waiting periods are over.
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Ann, I just signed up for this after 2 clients insisted on it. Problem I have, and they have is the high cost. Plus, you have to get appointed with them through Black & Gould, the only agency in AZ allowed to sell the indi plan. To top it all off, the 5% commission isn't worth anyone's time. The $1.50/mo for the $30/mo premium won't pay for fumes in my gas tank.
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