Post on 08-Jun-2015
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
About SDC
• Celebrating Over 27 Years Providing Dental Benefits
• Developed, Owned and Directed by Our Participating Dentists
• Benefits Designed by Dental Professionals
• Profits Held to Less Than 5%
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Superior Difference
• Network Contingency Reserve Fund– Helps Offset Clients’ Actual Dental Utilization– Shared Risk = Manageable Renewal Rates
• Superior Service– Receptionist-Managed Phone System– Calls Answered Within Three Rings – 98% First Call Resolution– Less Than 1% Claim Errors
• Contract Period Determined by Group• No Waiting Periods• No Missing Tooth Clauses• No Balance Billing In Network
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Service Area
Serving Ohio, Kentucky, and Indiana
Selling to Groups Domiciled in These States
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Nationwide Network
Nearly 8,500 Network Access Points!
SDC Can Grow Our Network Beyond Our Service Area to Meet Membership Demand!
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Plan Options
• The Preferred Plan– Network-Driven Dental Plan
• The Direct Plan– Dental Reimbursement Plan
The Preferred Plan
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
• Network-Driven Coverage• 8,500 Network Access Points
(and Growing!)
• All specialties covered
Available Throughout All Counties In:• Ohio• Kentucky• Indiana
Group Size:• Minimum of Two
Enrolled Employees
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Preferred Plan
Features: • Open Access – Client Determines In and Out of Network Coverage Levels• Network-Only Option Available Upon Request• Available Fully-Funded or Self-Funded• Contributory, Voluntary, or Shared Employer/Employee • Contract Period Determined by Group• No Participation Requirements • No Claim Forms or Balance Billing (in network)• Unique Ortho Benefits – No Penalty for Prior Usage (Unless Group
Specifies) • Co-Pays Available on Preventive Oral Evaluations (Determined by Group)• Pediatric – Essential Health Benefits Available for Groups Under 50
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Direct Plan
• Dental Expense Reimbursement• Dollar-Driven vs. Benefit-Driven
Available:• Nationwide Without Network Option• SDC Service Area With Preferred Network Option
Group Size:• Minimum of 50 Eligible Employees
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Direct Plan
Features: • No Network - See Any Dentist Nationwide• Preferred Network Option Available for Even Greater Savings• No List of Covered Services for Most Flexibility • Add List of Covered Services for Greater Savings• Self-Funded• Contributory, Voluntary, or Shared Employer/Employee • Contract Period Determined by Group• Quick Reimbursement
No-Cost Extras
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Included At No Additional Cost With All Plans:
SMILERIDER• 15% Discount on Cosmetic/Elective Dental Procedures Available Through
Participating Providers
EyeMed Vision Discount Plan• Discount Card Offering 15-20% Average Savings on Vision Services and
Products – No Limit to Usage
ThinkHR Comply• HR Compliance Resource Center Available Exclusively to Our Clients
Who Sign Up for Superior Direct Connect, Our Online Account Management System – A Value Of $575
Buy-Up Option
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
COBRA• Full Service COBRA Administration• Available With Any SDC Plan• Powered by Ceridian
Funding Options
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Fully-Funded • Available on Preferred Plans
Self-Funded• Administrative Services Only• Available on Direct and Preferred Plans
Funding Options
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Fully-Funded• Competitive Rates• 3-5% Average Renewal Trend• Underwritten Rates Available for 51+ Eligible Employees• Community Rates Available for 50 or Less Eligible Employees• Groups between 30-50 may select either the Community Rated
options or Individually Underwritten Options
Funding Options
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Self-Funded / Administrative Services Only (ASO) • Minimum Group Size: 50 Eligible Employees • Claims Savings Through Network• Administration Fee Includes:
– Claims Administration– Member Materials
(Including EOBs)– ID Cards– Reporting
– Full SDC Service
– Network Access– No Initial Start-Up Cost– SPDs Upon Request
(Additional Charge May Apply)
Group Categories
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Groups of 51+ Eligible Employees• Customized Plan Designs• Underwritten Rates• LOCS: Standard, Adopt, Modify, Modify+• Multi-Year Rate Guarantees May Be Granted
Groups of 50 or Less Eligible Employees• Community-Rated Plans• Set Options Available With Limited Customization• Standard LOCS
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Requirements For Quote:• Census of Eligible Employees, Zip Codes, Tier Structure,
Waivers and COBRA• Current and Renewal Rates• Current Carrier• Current Plan Design• Current LOCS (Any Required Matches)• Employer Contribution• Group’s Effective Date• Due Date of RFQ
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
List of Covered Services (LOCS) Can Be Altered Per Group Size:
• Groups Over 100 Eligible Employees– Adopt – Program Current Carrier’s LOCS In SDC System As-Is– Modify – Move Services– Modify+ – Move Services and/or Add/Alter Frequencies/Limitations
• Groups 51-100 Eligible Employees– Modify – Move Services– Modify+ – Move Services and/or Add/Alter Frequencies/Limitations
• Groups 30-50 Eligible Employees (If Individually Underwritten)– Modify – Move Services
• Community-Rated Groups (50 or Less Eligible Employees)– Standard LOCS– No Exceptions Made
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Differences in LOCS to Look For:
• Services Commonly Found in Different Categories (Preventive, Basic, Major, Ortho, or Class I, II, III, IV):– Endodontics– Periodontics– Sealants– Space Maintainers
• Trending Additions to LOCS:– Dental Implants– Extra Cleanings
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Network Reports Available Upon Request:• GEO Access Report
– Prepared for Quotes of Groups Over 100 – Employee Zip Codes Required
• Disruption Report– Prepared for Quotes of Groups Over 100– Requirements:
• Provider Names• Tax ID Number• Provider zip codes • Provider address (not required but helpful) • # of Claims (not required but helpful)• $ of Claims (not required but helpful)
Renewal Process
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Underwritten Groups (Any Size)• Signed Addendum Required • Renewal Addendum Emailed to Broker 90 Days in Advance of Renewal • Follow-Up Sent to Broker 30 Days in Advance of Renewal
Community-Rated Groups (50 or Less)• Renewal Emailed to Broker 60 Days in Advance of Renewal• Community-Rated Plan Sheets Always Available on Website
– Rates Published in September for Upcoming Year– Rates on Community-Rated Plan Sheets are Same For New & Renewing
Groups
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Account Management Team Structure:
• Manager of Account Sales – Oversees the Account Executives and the Account Sales Team
• Account Executives (AE) – New Business and Renewals, Initial and Renewal Employee Enrollment Presentations
• Manager of Account Services – Oversees the Account Coordinators and the Accounts Services Team. Manages Accounts 500+ Enrolled Alongside the AE for Additional Support and Representation for the Client and Broker.
• Account Coordinators (AC) – Process and Send Renewals, Manage Service (Claims, Enrollment and Billing) Inquiries, Report Requests, Membership Reports. Table Sits and Benefit/Health Fair Booth Representation.
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Contact Structure:
• 500+ Enrolled: Account Executive Lead Contact, Manager of Account Services Secondary Contact, Account Coordinator Support…Complete Team of Account Management!
• 51-499 Enrolled and Underwritten Accounts: Account Executive Lead Contact, Account Coordinator Secondary Contact
• 50 Enrolled or Less and All Community-Rated Plans: Account Coordinator Lead Contact, Account Executive Secondary Contact
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Underwritten Groups - 51+ Eligible Employees:
• Account Executive (AE) – First Contact Point for Day to Day Needs– Available For:
• Enrollment Meetings (for groups 51+)• Presentations• Table Sits
• Account Coordinator (AC)– Prepares and Delivers Renewal to Broker and AE– Supports AE in Day to Day Needs– Client Report Requests for Groups of 100+ Eligible Employees
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Community-Rated Groups – 50 or Less Enrolled Employees:
• Dedicated Account Coordinator– Day-to-Day Service Needs of Broker – Prepares and Sends Renewal to Broker – No Outside Service
• Self-Service Available Online (For All Group Sizes)– Community-Rated Plans/Rates – Group Application– Employee Enrollment Form– Direct Connect – Secure Account Management Portal
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
ThankYou!
Questions?