Dental benefits are often neglected because employees tend to pay more attention to their medical benefits and this may be particularly true leading into this year's open enrollment period.
"Dental is often forgotten because of the importance of the medical benefits but it's becoming more and more evident that it's an important benefit to preserve your oral health and your overall health," says Dr. Gene Sherman, senior vice president of business development and professional relations with AlwaysCare Benefits. "The Affordable Care Act has put some focus on the prevention and wellness, and dental works well with that."
Jolynne Williamson, AVP, group dental product development with Guardian, agrees that "for the most part, it's all about medical and just a little bit about dental and vision.But for dental carriers, that little bit is a really big deal."
EBN asked Sherman, Williamson and other dental benefits professionals for their thoughts on some of the leading trends affecting the industry. Here's what they had to say.
On employees' desire for dental
"All the surveys indicate that dental is one of the most sought after benefits in the employment marketplace. There's still demand. The demand is for PPO [preferred provider organization] products because PPO still has the largest market share of all dental benefits." -Dr. Gene Sherman, AlwaysCare Benefits
"One-in-two [employees] or more would prefer to sign up for dental coverage at their worksite. So that's an important thing for employers to think about." -Keith Pellerin, vice president of product management and innovation, Aflac
On connecting dental benefits to wellness
"We partnered with a firm on a risk assessment tool that fits in to the medical model of health risk assessments. ... The future is to tie it in to employer programs to better align it with their medical health risk assessments." -Steven Fleischer, vice president, sales and marketing, Delta Dental of New Jersey
"It's not so much 'let's pull dental into an already comprehensive wellness package,' as much as it is employers recognizing that if they leave dental off the table they're not really covering the entire wellness of their employees." -Keith Pellerin, Aflac
"I would say there's a desire to [connect oral health to a broader wellness program] but with the lack of diagnosis codes in dentistry it's difficult to do. ... Dentistry doesn't have that luxury of seeing those [medical] diagnosis codes unless you're in a situation where you're working with a medical plan and they're providing you with that information." -Dr. Gene Sherman, AlwaysCare Benefits
"We're seeing more requests-for-proposals from groups where they ask if we have that [mobile] capability. And when they ask if we have that capability it's because employees are asking employers for that capability. When we see it being asked for in RFPs we know it's being well received." -Jolynne Williamson, Guardian
On health care reform
"There's an interesting trend happening - and part of that could be because of the Affordable Care Act - and that is we're seeing an increase in self-funded plans vs. insured plans." -Dr. Gene Sherman, AlwaysCare Benefits
Pediatric dental and vision services are one of 10 essential health benefits carriers are required to include in their small group and individual policies beginning in 2014. Groups can either buy their dental benefits embedded in a medical plan or from a dental carrier.
"We understand health care reform is really big, especially for the small group employers. They're going to have a lot of decisions to make about their health insurance, one of which is: Where do I buy my pediatric dental benefit?
The essential health benefits can vary by state and carrier - for example, the essential health [dental] benefit a medical carrier may embed in their medical policy may be different than what a standalone dental carrier might offer when they add the essential health benefit to the dental plan. If anything, I would encourage employers to ask - before they make the decision about what to do with their dental benefit - what is that pediatric dental benefit that you've embedded in my medical policy? Let me know the details. Are there limitations?" -Jolynne Williamson, Guardian
On voluntary plans
"We're seeing health care, in general, being increasingly top of mind with many households and individuals. In the last three to five years, we've seen a growing trend in recognizing and incorporating voluntary dental benefits in that planning process." -Keith Pellerin, Aflac
"Some smaller employers will go to defined contributions. We've seen an increase in voluntary dental over the past several years. It does make it easier for people to manage the acquisition of their coverage." -Dr. Gene Sherman, AlwaysCare Benefits
"When employers are making a decision, they're looking at cost and how broad the network is because a broad network means there's a greater chance the employee's dentist is in the network. But when an employee looks at it, their question is: Is my dentist in your network? They're not really concerned with the breadth of the network but concerned with their own dentist. ... We've really started to see an increase in demand from employers for plans that penalize employees for going to an out-of-network provider or, stated differently, plans that incentivize employes to go to an in-netowrk provider." -Jolynne Williamson, Guardian"
"We're seeing a trend where people don't want to be constrained in the provider they go to. The expansion of programs that don't constrain the selection of providers is another trend we've seen." -Keith Pellerin, Aflac
On industry growth
"Dental enrollment has been pretty much flat over the past couple of years, and I say that because there's been an increase in enrollment but when you normalize for the increase in the population, it's very small.
We're also noticing that the fastest growing segment is between the group size of 25 to 100 [lives] whereas in years past the fastest growing group size segment was 25 and under." -Dr. Gene Sherman, AlwaysCare Benefits
On premiums and affordability
"We've seen four out of 10 [employees] saying they're interested in stable annual coverage amounts. They don't want to see significant fluctuations from coverage period to coverage period. ... People want to really focus on managing their household budgets and minimizing volatility that comes from out-of-pocket expenses." -Keith Pellerin, Aflac
"There's been a cry from organized dentistry that annual maximums don't increase and for a long time that was true but that's changing. Premiums have been very stable over the last couple of years. It's been very price competitive so premiums have been very stable, probably less than the inflation rate, or close to it." -Dr. Gene Sherman, AlwaysCare Benefits
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