Can anyone share a little light on who they might be writing individual dental insurance through and their state, not a discount plan but either a ppo &/or an indemnity scheduled?
Good question. All I got is AHCP dental. There must be better out there, but it's all I got right now outside of the MM carriers who I never sell dental through. I would be interested also in a DMO or PPO dental carrier that is best to go through.
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All individual dental plans are a complete waste of money.
I would have to agree from the plans I have taken a look at. I remember having great dental with group coverage through one of my previous businesses. Not sure why individual dental is lacking. And, the group dental I had was only $13 a month of pay period, I forget.
Not sure why individual dental is lacking. And, the group dental I had was only $13 a month of pay period, I forget.
Individual dental is a dollar swap at best for the insured and only marginally profitable for the carrier.
Group dental is very profitable for carriers . . . much more so than medical. It is a good deal for the consumer only if the employer pays a significant portion of the premium, which is usually the case.
Individual dental is a dollar swap at best for the insured and only marginally profitable for the carrier.
Group dental is very profitable for carriers . . . much more so than medical. It is a good deal for the consumer only if the employer pays a significant portion of the premium, which is usually the case.
What carrier, if any, do you put your clients on for dental?
Do the math folks, dental is a waste of money (echoing Somarco) and I would question your "putting the client first" if you're selling dental and not DI or LTC or Life Insurance first..... but then again, you got mouths to feed, I understand, I understand.
Team Work: Someone else to blame when things go wrong!
Im talking dental simply since I get several requests a year for it, it would be nice to have something decent to at least offer. I really want it just to use it to get in the door with, then start talking about some other coverages....but I agree it's not the best spent money.
Indmedis, whats your take on that ahcp dental plan?
If your in WA state look at Regence BS. They have an individual dental. Not the best, far from the worst, but there simply aren't alot of choices out there for individual dental plans. WDS is the best far and away in WA state.. good coverage and stable rates (read small to no rate increases) and good service. Unfortunately they don't offer individual..
All individual dental plans are a complete waste of money.
Really? Thats only your opinion, and I agree to a certain point. Remember, Clients and Prospects are not you.
I honestly Believe Co-pay plans are a complete waste of money, but I enroll indivduals everyday into them. I only worry about what is important to the client, not my personal opinion or try to "sell" them on HD or HSA plans, like most do, because thats thier personal belief, and they want to spread thier great wisdom, I hear it from Clients everyday about Agents. (Listen to the Client)
No Dental plan is perfect but I have several clients since AHCP released the Dental Plans, the Comprehensive plan, is probably better than anything right now on the market.
Dental care is inflationary like everything else, except not at the same rate as medical care. Dental insurance is very profitable and there is little need, especially with individual products, to raise rates.
As for the AHCP plan, let's dissect it.
Family on the low plan pays $570 per year. Let's say there are 4 in the family and each has the twice yearly exam.
My semi-annual exam runs $140 so let's say I bought the plan.
That's $1120 per year out of pocket.
With the AHCP plan I have a $25 deductible x 4 = $100.
I would have to pay 20% of the remaining $1020 = $204.
Total OOP = $570 + $100 + $204 = $874.
Sounds like your plan is a deal, unless . . .
The max allowable charge is less than the $140 my dentist charges.
Dental plans use ADA schedules and then only allow a percentage of the ADA amount . . . typically 65% but some of the better (more expensive) plans will allow as much as 80% of the ADA guideline charge.
The ADA allowance for routine checkup and cleaning is $126 in my area. Giving the AHCP plan the benefit of the doubt, let's say they reimburse at 75% of the ADA allowance.
Dental care is inflationary like everything else, except not at the same rate as medical care. Dental insurance is very profitable and there is little need, especially with individual products, to raise rates.
As for the AHCP plan, let's dissect it.
Family on the low plan pays $570 per year. Let's say there are 4 in the family and each has the twice yearly exam.
My semi-annual exam runs $140 so let's say I bought the plan.
That's $1120 per year out of pocket.
Good God, Bob I could do the same thing with any product. Once again, You believe it to be a waste of money, but once again, that does not matter.
With the AHCP plan I have a $25 deductible x 4 = $100.
I would have to pay 20% of the remaining $1020 = $204.
Total OOP = $570 + $100 + $204 = $874.
Sounds like your plan is a deal, unless . . .
The max allowable charge is less than the $140 my dentist charges.
Dental plans use ADA schedules and then only allow a percentage of the ADA amount . . . typically 65% but some of the better (more expensive) plans will allow as much as 80% of the ADA guideline charge.
The ADA allowance for routine checkup and cleaning is $126 in my area. Giving the AHCP plan the benefit of the doubt, let's say they reimburse at 75% of the ADA allowance.
Despite math errors, I see the bottom line does reflect a wash on premiums, deductibles, etc. FOR ROUTINE PREVENTIVE DENTAL CARE.
But, Dental Insurance is like all other Insurance, and that is, it is there to protect against unforseen catastrophies. Suppose someone in the insured family has an abcessed tooth, or breaks a tooth and needs a crown, etc. etc. etc. I would not want to be without a comprehensive dental plan any more than I would want to be without a comprehensive medical plan. I may be healthy today, but I want to protect against that day I am not so fortunate.
As far as sales is concerned, I would not think it a good product to lead with, but like others have posted, it should be part of your bag for clients who ask for it.
Add: A note about indemnity plans: These are similar to mini-meds, i.e., you should make sure your client knows the difference between comprehensive and limited/scheduled benefit plans. Limited benefit plans are only cost effective to those who are financially strapped. That may be all they can afford, and this is a way to pay on a budget. If you are financially stable, you really need to protect against financial disaster with a comprehensive product. Another argument is to protect against refusal of necessary health services for that family member in need. I wouldn't want to have a limited benefit policy and no savings if my child needed emergency oral surgery where it would be declined because of lack of coverage.
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Last edited by retread : 05-08-2008 at 01:15 PM.
Reason: add comment
Suppose someone in the insured family has an abcessed tooth, or breaks a tooth and needs a crown, etc. etc. etc. I would not want to be without a comprehensive dental plan any more than I would want to be without a comprehensive medical plan.
1) You can't access those benefits until you have had the plan for more than 12 months. So what happens if you break a tooth, need a crown, etc during the first 12 months?
2) The max benefit on most plans is $1000 . . . payable at no more than 50% of the allowable charge.
Of course that $1000 includes any preventive benefits you have already (or may intend to) use during the year.
So how much is a crown?
I have had 5 in the last 4 years. $1350 each.
What is the ADA allowance?
$981.
What would a typical plan pay?
$981 x .75 x .5 = $368 . . . leaving me owing $982.
Most of the dental plans available to individuals are either discount plans (with some merit) and indemnity plans (such as the one described).
A few are DHMO plans (such as from Delta Dental) with strict fee schedules (as long as you use a par dentist). Most of those do not have waiting periods like indemnity plans and do provide some value.
Dental insurance is like maternity insurance. Something else to waste your money on.
1) You can't access those benefits until you have had the plan for more than 12 months. So what happens if you break a tooth, need a crown, etc during the first 12 months?
2) The max benefit on most plans is $1000 . . . payable at no more than 50% of the allowable charge.
Of course that $1000 includes any preventive benefits you have already (or may intend to) use during the year.
So how much is a crown?
I have had 5 in the last 4 years. $1350 each.
What is the ADA allowance?
$981.
What would a typical plan pay?
$981 x .75 x .5 = $368 . . . leaving me owing $982.
Most of the dental plans available to individuals are either discount plans (with some merit) and indemnity plans (such as the one described).
A few are DHMO plans (such as from Delta Dental) with strict fee schedules (as long as you use a par dentist). Most of those do not have waiting periods like indemnity plans and do provide some value.
Dental insurance is like maternity insurance. Something else to waste your money on.
I don't know what policy you are quoting from, but a PPO dental plan would take that $1350, subtract the negotiated discount, leaving say $981, then applying the deductible ($50 or $100) lets say $100. You pay 50% co-pay on the remaining balance ($881 x .50= $440.50). I'd say $540.50 (not counting the monthly premium) is a not too bad of a deal.
Last edited by retread : 05-08-2008 at 03:29 PM.
Reason: miscalculated co-pay
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