Transcript Power Point Presentation of MWG Dental Program

Dental Product Overview
Agenda
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Who is DBP?
Who is MorganWhiteGroup (MWG)?
The MWG Dental Plan/DBP Partnership
Dental Product Overview
Underwriting Guidelines and the Quoting Process
The Dental PPO Network
Sales Support Tools/Marketing Materials
Case Installation
Preparing yourself to Sell Dental
Questions and Answers
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Who is DBP?
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Founded in 1984
Turnkey - Dental outsourcing specialist
Private-label focus and philosophy
Headquartered in Rockville, MD
Serving over 3 million members
National PPO network - over 55,000
dentists
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Who is MorganWhiteGroup?
• Founded in 1987
• Headquartered in Jackson, Mississippi
• Over 15 years experience marketing Voluntary
Dental Plans.
• Over $50 Million in Health and Supplemental
Benefits Premium in force.
• Over $10 Million in Voluntary Dental Premium.
• Provides administration services for over 30
insurance companies.
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Dental Product Overview
• Plan Options
• Voluntary and Contributory
• Indemnity (Traditional)
• Passive PPO
• Incentive PPO
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Dental Product Overview
Indemnity Dental Options
• One Plan design available
– The Benchmark Plan (MWGI1001)
• No Network - Freedom to utilize any provider
• Services paid at the 85th percentile of HIAA
(member responsible for any charges not covered by plan)
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Dental Product Overview
Passive PPO Dental Options
• Two Plan Designs Available
– The Open Choice Plan (MWGP1001)
– The Opportunity Plan (MWGP1003)
• In and Out-of-Network services covered at the same benefit
levels
– In-Network members pay only negotiated fees for covered services (no
balance billing)
• Freedom to choose any Dentist
• No referrals required for Specialty Care
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Dental Product Overview
Incentive PPO Dental Options
• One Plan Design Available
– The Incentive Plan (MGWD1002)
• Covers both In and Out-of-Network benefits
– Richer benefits available for In-network services
– No balance billing to member In-network
• Freedom to choose any Provider
– Maximum member savings In-Network
• No referrals needed for Specialty Care
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Dental Product Overview
Custom Dental Plan Options
• Build the plan you need to compete
– Indemnity, Passive PPO and Incentive PPO
– Voluntary and Contributory Plans
• Group Qualification: 200+ eligibles
• All quote requests come to MorganWhiteGroup at:
[email protected]
– RFQ must be accompanied by complete data
requirements
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New Basic Dental Plan
Underwritten by United Healthcare Insurance Company Rated
A+ Superior by A.M. Best
• No Deductible
• No Waiting Periods
• Out of Network paid at the 85th
Percentile of UCR
• $1,000 per person per year
maximum
• Diagnostic and Preventative
paid at 90%.
– 1 office visit, Exam, 1 set of
bitewing x-rays, and cleaning
every six months
• Fillings and Simple
Extractions paid at 80%.
– One, two, three, and four
surface amalgams and simple
extractions
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MorganWhiteGroup Dental Plans
Plan Name:
MW Plan Code
UW Plan Code
Plan Type
Reimbursement Method In/Out
Diagnostic & Preventive
Minor Restorative
Endodonitcs
Periodontics
Oral Surgery
Major Services
Ortho (Child Only)
Deductible
Ded waived for D&P
Annual Maximum
Ortho Lifetime Maximum
Waiting Periods
New Groups:
Takeover Groups:
The Benchmark
Plan
MWGI1001
I1057
Indemnity
UCR
100
80
50
50
50
50
The Open Choice
Plan
MWGP1001
P2603
Passive PPO
DPO/UCR
100
80
50
50
50
50
50
$50/150
Yes
$1,000
$1,000
50
$50/150
Yes
$1,000
$1,000
The Incentive Plan
MWGP1002
P2604
Incentive PPO
DPO
UCR
100
80
80
60
50
40
50
40
50
40
50
40
50
$50/150
Yes
$1,000
$1,000
40
$50/150
Yes
$1,000
$1,000
The Oppurtunity
Plan
MWGP1003
P2605
Passive PPO
DPO/DPO
100
80
50
50
50
50
50
$50/150
Yes
$1,000
$1,000
12 months for Endodontics, Periodontics, Oral Surgery & Major Services (all enrollees)
No Waiting periods for enrollees & their dependents who were enrolled in employer's prior plan.
DPO Reimbursement based on the negotiated provider fee schedule; UCR Reimbursement based on Usual, Customary & Reasonable (UCR) charge.
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Underwriting Guidelines
Dental Quoting Process
• Groups under 200 eligibles/enrolled will be quoted from
your General Agent or directly from MorganWhiteGroup.
– Internal MWG Dental Process:
• Direct all rate requests to [email protected] or Fax
request to Robin Williams at 1-601-956-1702 or call 1-800-8001397 or 601-956-2028 ext. 116.
– Data elements needed
• Situs zip code
• Current Rates (copy of current billing, states and current
enrollment by tier
• Effective date of coverage
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Underwriting Guidelines
Quoting Process - 200+ Groups
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Build the plan you need to compete.
– Passive PPO, Incentive PPO, Indemnity
– Group Qualification: 200+ eligibles
All quote requests come to [email protected]
• Data requirements
• Group Name, Effective Date, and SIC Code
• Census File (with age, gender, zip code, and enrollment tier of each employee)
• Employer’s Zip Code, Specific Broker Commission Percentage, Whether group is
voluntary or contributory, and Current and Proposed Plan Design(s).
• Historic Claims vs. Premium reports (3 years of history)
• Underwriting will return a quote via email with in 7 business days.
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Underwriting Guidelines
Quoting Process - 200+ Groups
• All 200+ groups quoted by MorganWhiteGroup
– Standard plans and Custom plans
• Underwriting Response will include:
– Rate Proposal and Underwriting Confirmation Form (including
Assumptions and Considerations)
– Exclusions and Limitations
– Custom Benefit Grid (custom plans for groups over 200)
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Case Installation Process
Workflows and Forms
Workflow
• Prepare Group Quote
• Obtain Group Application
• Coordinate Enrollment
• Send all Enrollment Materials to MorganWhiteGroup
• Distribute Group Policy and Employee Certificates
• Dental Claim Forms
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The Dental PPO Network
Network Information
• Locating a Network Dentist:
– Toll Free: 877-778-4104
– Go to www.mwgdental.com website and touch member services
button. Then dental provider search page
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Sales Support Tools/
Marketing Materials
Collaterals and Tools
• Product Brochure
– Plan Design grid
• Short Proposal
• MWGDental.com Website
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Member Services and Claims
• Dental Claims Address:
Morgan White Dental Claims
P.O. Box 30566
Salt Lake City, Utah 84130-0566
• MWG Dental Member Services Number:
Toll Free: 877-778-4104
• Locating a Network Dentist:
– Toll Free: 877-778-4104
– Link from www.mwgdental.com website to members button and
then dental provider button for dental provider search page
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Preparing Yourself to Sell Dental
Tips on Comparing plans
• Know your dental terminology
• Things to look for in other plans:
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Class shifting
Waiting periods
Annual plan maximums
Plan benefits vs. discounts
• Gather specifics about existing plan
– plan design/certificate of coverage
– current and renewal rates
– claims experience
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Dental Facts and Figures
• Do Employees want Dental?
– Yes! Dental is the 2nd most popular ancillary health benefit.
175 Million people in the United States currently have dental
coverage.
• Will offering Dental benefit my Employer?
– Yes! Through increased productivity. 2.5 Million work days are
lost each year due to dental problems.
• Will the Employer’s Employees benefit from a Dental plan?
– Yes! Good oral health promotes good overall health.
Periodontal (gum) disease has been linked to heart disease
and low birth weight in babies. A dental benefit encourages
total health and well-being for employees.
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