Colby College Effective Date: January 1, 2019 Group Number: 62582
About Delta Dental Dental is what we do. We were the first. We are the dental industry’s experts We are consistently rated as the best dental benefits company in the nation Not-for-Profit with strong community partnerships Local company with national capabilities (seamless national network) Main Street, not Wall Street feel
Delta Dental by the Numbers Delta Dental covers more than 78 million people in over 146,000 groups across the United States → We cover 1/3 of those with dental insurance → We cover nearly 1/2 of the Fortune 1000 companies 93% of members surveyed were very satisfied/satisfied with Delta Dental Our national subscriber retention rate is 90.13% (97.5% in ME)
Delta Dental Provider Networks You can see any dentist Two provider networks – The largest locally and nationally → 80% of dentists nationally are in the Delta Dental Premier® network (83% in ME) → 50% of dentists nationally are in the Delta Dental PPO® network (59% in ME) 93% of all claims submitted to Northeast Delta Dental are paid to network dentists → No balance billing; No up-front payment; No claims paperwork
Dental Monthly Rates Coverage Type Total Premium College Portion Employee Portion Individual $39.00 $31.00 $8.00 Employee + 1 $72.00 $43.00 $29.00 Family $131.00 $79.00 $52.00
Full Charge of Procedure Delta Dental’s Allowance* Here is an example of how the Delta Dental PPO plus Premier arrangement works: Delta Dental PPOSM Delta Dental Premier® Non-Network Dentist Full Charge of Procedure $1,000 Delta Dental’s Allowance* $800 $900 $1000 Coinsurance Percent 50% ($400) 50% ($450) 50% ($500) Patient’s Payment $400 (800 - $400 = $400) $450 ($900 - $450 = $450) $500 ($1,000 - $500 = $500) *Because Delta Dental network dentists have agreed to accept a lower reimbursement for services, subscribers have higher benefits and lower out-of-pocket costs. This means real cost savings.
Example – Prorated Ortho Case: Total Case Fee (Including records, retention, and post-treatment recall exams) $5,000.00 Total Approved Case Fee Contract Maximum $1,500.00 Active Months in Treatment 36 months Length of Active Treatment remaining* 8 months Co-Payment % 50% Northeast Delta Dental’s Total Liability $ 555.55 ($ 5,000/36 = $ 138.89 X 8 = $ 1,111.11 x 50% = $ 555.55) Monthly Payments $ 69.44 (7 months) Final Payment $ 69.47 *The estimate for remaining length of active treatment is based on the experience of similar past cases. In the few cases where the length of active treatment exceeds the estimated treatment time remaining, Northeast Delta Dental will, upon request, review the case for any additional payment that is determined.
Patient-Centered Dental Benefits
Benefit Look-Up www.nedelta.com Print ID cards View benefits, claim, EOBs Find a Dentist Register for SmileCoach® Read you Dental Plan Description booklet Download forms
ID Card Sample Receive two ID cards to your mailing address Both ID cards in primary subscribers name Print more as needed via Benefit Look-Up or download our Mobile App Dentists can verify coverage and submit claims without ID cards as well
Questions