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Creating Smiles

Create low-cost dental insurance plans based on employee utilization.

By Theresa McConeghey

If you want dental insurance sales ideas that can easily be customized to each of your client's needs, take a look at employee utilization reports. The best way to keep dental benefit costs in check is to match the provisions your clients offer with the services employees actually use.

According to LIMRA International research, one in five employers considered making changes to their dental designs to cut overall benefit costs in 2010. That trend will most likely continue in 2011.

You can help your clients, whether they are looking to make changes or not, when you propose a cost-saving idea customized specifically to their needs.

Cost-saving sales ideas
Based on member utilization, you can put a number of innovative ideas to use immediately. These ideas are based on a collection of member data and can easily be applied in your market.

• Take time to evaluate provisions. Provisions used by a small portion of a group can drive up the overall cost of dental benefits.

Crowns, for example, make up only 2 percent of claim procedures submitted. However, crowns are a very expensive procedure. That 2 percent of submissions represent about 11 percent of the claim dollars paid.

Other provisions with low usage include dental implants, composite fillings on molars and porcelain crowns on molars. Ask clients whether or not these provisions are necessary. If not, a simple change could help them achieve instant savings.

Less than 10 percent of the population seek care for root canals, gum disease and oral surgery. By moving endodontics (root canal), periodontics (gum) and oral surgery benefits from basic to major, clients can save significant premium.

• Reduce maximums. Many members do not reach their annual maximum amount. In fact, only four of every 100 dental members ever reach their $1,500 annual maximum.

Reducing the maximum can offer significant savings, especially in conjunction with a benefit that helps employees rollover unused portions of their maximum from year to year. Clients also save when preventive procedures do not count toward the annual maximum.

• Reward network usage. Got a client with employees who visit non-network providers? Suggest he or she make changes to reward and encourage network usage.

Your client could offer standard in-network coinsurance and a slightly lower non-network coinsurance. He or she could establish a standard in-network maximum of $1,500 and a lower non-network maximum of $1,000 or $750.

Another option is to lower the usual, customary and reasonable rate to a different percentile. This lowers rates because members have higher out-of-pocket potential when visiting non-network providers.

• Choice of benefits. Offering a dental design with a choice of benefits is a good way to provide the coverage employees want at a price employers can afford.

For example, an employer pays for a core dental benefit, with an option for employees to buy additional voluntary coverage. Because almost seven out of 10 dental claims are for preventive services, the core option offers comprehensive benefits for employees who seek only preventive care. For those who need additional care, the buy-up of voluntary coverage is an affordable option.

The next step
To customize these ideas for your clients, request a utilization report or any other reports that carriers offer to track usage. You can proactively make recommendations—now or at renewal—based on the benefits really being used. Your clients will benefit from comprehensive dental benefits at a cost they can afford.

Theresa McConeghey is assistant vice president of group insurance for the Principal Financial Group in Des Moines, Iowa. MarjiHamann is director of sales for group non-medical products at the Principal Financial Group in Chicago, Ill.

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