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Effective Discount Study Results 2016
Ruark Consulting has published their annual independent study comparing dental claims data from Delta Dental and 14 other national companies offering dental insurance against a baseline of average industry charges. The study examined actual Delta Dental claims data for the 2016 calendar year along with the actual claims data from 14 other companies including CIGNA, Dental Network of America, Guardian, and MetLife.
The study revealed that Delta Dental leads the industry, both nationally as well as in Colorado, on effective discounts. Across all claims, both in-network and out, our network and negotiations with dentists save billions of dollars compared to average charges every year. For more information on the study, contact your account manager.
Annual Report
Our 2016 online annual report, The Transformative Power of a Smile, is now available online. Read all about how Delta Dental of Colorado has been working to bring Smile Power™ to all Coloradans. We know the power that a healthy smile has to transform a life, and the annual report highlights the programs, products, and people that helped support our mission of improving the oral health of the communities we serve. We are focused now more than ever on new products, new ways of thinking about dental benefits, new ways to support our mission, and new ways of making dental insurance, dental care, and good dental health more accessible to more people. Check out everything we accomplished in 2016.
Updated Policy on Non-covered Services
The Colorado state legislature recently passed legislation (SB-190) proposed by the Colorado Dental Association that prohibits dental plans from holding network dentists to their contracted fees for any dental procedures that are not "covered services," effective for dates of service starting August 9, 2017. Delta Dental of Colorado will comply with this new legislation in a manner that is consistent and easily understood.
Covered services are defined as "dental care services for which reimbursement is available under a covered person's plan, or for which a reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other contractual limitations."
This legislation will impact Delta Dental members (and all other insurance companies) to some degree in the form of higher out-of-pocket costs if they choose a procedure that is not covered by their plan. However, it should not be significant because most dental procedures required to prevent and treat dental disease remain "covered," meaning they are billable at the contracted rate. Most "non-covered" services, by contrast, tend to be cosmetic and/or optional.
Payment policies that govern the handling of non-covered services do not affect group premiums and/or our administrative-services-only (ASO) rates because there is no reimbursement by either Delta Dental of Colorado or our self-funded group plans. Non-covered services, whether paid at the submitted or contracted fee, remain services for which enrollees must pay the full charge.
The following examples may help illustrate "covered" versus "non-covered" services:
- If tooth whitening is not covered under a given group contract, submitted fees will be honored.
- If a plan covers two cleanings per calendar year, a third cleaning within a calendar year is denied due to a "frequency limitation." Because cleanings are covered by the plan, this third cleaning is still a "covered service" and will be held to the contracted fee for cleanings.
- A posterior composite is often subject to an "alternate benefit," so it will be considered a covered service because DDCO provides a benefit up to the cost of an amalgam. This legislation will not change the processing of such claims, and providers will continue to be held to the fee for the actual service rendered, even if it is an alternative to the allowed procedure.
If you have additional questions about this legislation, please contact your account manager.
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Senate rejects slimmed-down Obamacare repeal, as McCain votes no
The New York Times, July 27
, 2017
The Senate in the early hours of Friday morning rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, derailing the Republicans' seven-year campaign to dismantle President Barack Obama's signature health care law and dealing a huge political setback to President Trump.
New polls show how voters, employers feel about health care reform
Benefits Pro, July 13, 2017
American health care policy, and the attitudes surrounding it, have shifted dramatically over the last few years.
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11 benefits workers want
Employee Benefit Adviser, July 6, 2017
A strong job market is giving employees and job seekers an edge while putting pressure on employers and their benefits managers to draw top-notch talent.
Dental insurance expectations are changing
Benefits Pro, July 5, 2017
Even when they have insurance, 25 percent of consumers haven't gone to the dentist in the past year over fear of the cost despite the fact preventive care is usually fully covered.
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Massive Outdoor Retailer show officially coming to Denver
It's official: Denver will be the host city for the Outdoor Retailer show -- the largest show in North America for outdoor retailers -- starting in 2018.
Colorado income gains slip below U.S. in first quarter; housing prices climb
The Denver Post, July 3, 2017
Personal incomes in Colorado are rising at a slower rate than the rest of the country this year, according to first-quarter numbers from the U.S. Bureau of Economic Analysis.
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Colorado slips on CNBC's 2017 list of 'America's Tops States for Business'
Denver Business Journal, July 12, 2017
Colorado has dropped a few spots on CNBC's list of 'America's Top States for Business,' but it's still among the top states in the annual ranking.
Colorado's hottest jobs: Here are the 10 careers most in demand
Denver Business Journal,
July 5, 2017
When it comes to the hottest jobs, the field of technology rules, but other areas are fast catching up. So, which ones are most in demand?
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