Stripping Down Group Dental

Group Dental: a complex topic that may seem simple on the surface, but if you truly want to make an employer and employees happy, there’s more to it than rates.
Did you know that next to medical benefits, dental is the next sought after benefit?
It’s our opinion that it is better to offer it on a voluntary basis than not at all.  This is one of the many benefits that can be deducted before taxes and still help the employer save money.
So why is dental not as simple as we may think? Let’s delve a bit into the inner workings:
  • Maximum Annual Benefits
More often than not, the standard maximum annual benefit is usually $1,000, but are you aware there are options for $1,500, $2,000, and depending on the group size, even higher?
Tip: Some companies won’t count the preventative dollars used towards that maximum, which can help increase the actual benefit by several hundred dollars.
  • Deductibles
Ranging anywhere from $0 to $250 per person and up to three times per family,  a carrier may often increase the family cap from 2 times to 3 times to be a bit more competitive in the marketplace.
Tip: Lifetime deductibles are an option to encourage a group to stay with a carrier.  Once the lifetime deductible has been met per person and family member, no further deductibles are required.
  • How are the benefits paid?
It’s important to analyze where Endodontics and Periodontics are paid. Together with surgery and anesthesia, these are means to get the pricing down (and lowering or raising benefits to the employees).
Tip: This is where a rate is not simply a rate and you are really doing your client a disservice if that’s all you are reviewing. 
  • What about networks & how they function?
Closed network HMO’s only allow a member (unless an emergency) to receive benefits from a listed provider, and referrals are required for specialist services to be covered. The same is true with some carriers when they quote a MAC (maximum allowable charge) plan or a DHMO (Dental HMO).
Tip: Comparing a carrier that quoted a MAC plan versus a UCR (usual, customary, and reasonable) would be a mistake.  Let’s not forget that many individuals aren’t so lax to change dentists and if forced to do so may resent the employer and insurance carrier in the end.
  • It’s all in the details!
Before you quote your next dental plan, make certain to take these variables into account.  If this is a daunting task (which it can be if you are truly quoting the dozen or so carriers that are out there), please feel free to allow us to do the work for you.  We will make the process painless and the sale will be easier than ever before.
We look forward to working with you on your ancillary group cases this year!  Thank you for your loyalty and let us know what more we can do to help you in your group and disability solutions.
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Vacation All I Ever Wanted

 It’s a pretty incredible time of year if you’re living where seasons change.  The grass is still green, the leaves are changing colors and beginning to float to the ground, and there’s a crispness in the air.  While we want to bask in the present moment and enjoy all things Fall, we know that the holiday season is soon approaching.  And for many, that means travelling!

As insurance industry professionals we are hardwired and/or trained to educate others on ways to plan for the unexpected.  So if you, a client, or someone you know is anticipating overseas travel, an International Medical Insurance policy should be taken into consideration.

Why? Anything can happen!

Picture yourself savoring the taste of delicacies from a foreign land then uh oh, food poisoning! Or taking in your exotic surroundings and oh no, twisting your ankle! It can be aggravating enough to have to tend to these small things at home let alone a new place where you may not speak the language or know the lay of the land. This is where an International Medical policy steps in to help, especially if you need to be transported to another area to get the care you need!

Policies will vary based on needs, travel time, deductibles, and amount of coverage…but that’s why we are here to simplify and guide you through the various products and options available.

Common plans include:

  • Individual & Family
  • Business Travel
  • Employer Sponsored Group Plans
  • Student Exchange Programs, International Students, & Student Travel
  • Extreme Athletics & Adventure
  • Mission Trips
  • Marine Crew & Captain Members

 

Even if you have a tendency to over pack, do not fret! An International Medical Insurance policy won’t take up any space and you and your clients will be happy to have “brought it” along!

 

 

Safe Travels!

 

Melody

 

 

“Stars: They’re just like us”

Hayden Panettiere has never been on my favorite actress list but for the first time I’m a fan. In case you hadn’t heard, she checked herself into a treatment facility for postpartum depression.

As women we are expected to be pillars of strength when it comes to families (and let’s face it, everything), especially after bringing life into the world. But just because someone suffers from a mental illness (and that’s exactly what postpartum is) doesn’t make them any less strong. A woman has just created and birthed a tiny person, this is warrior goddess stuff here and beyond all the hormonal and emotional responses that occur it’s not uncommon to experience deep depression. So why don’t more people talk about it?

Remember when Brooke shields came out and wrote a book about this same topic? Do you also remembered how Tom Cruise publicly criticized her for taking anti-depressants after giving birth to her daughter?

Do we really have to dig deep on the “why” behind so many women keeping quiet about postpartum? Or why so many keep quiet about any mental illness? Shame. And the shame keeps those that need help from getting it. So on top of the illness, add shame, and then sprinkle on judgement from society. What human can harbor all of that?

To go even further what if the treatment you need requires you to take time away from your job? What if you’re not a celebrity with a hit show and hit movies with a celebrity spouse both bringing in millions of dollars of income? How would you continue to earn an income and provide for your family, cover basic expenses, and medical expenses? How does one heal from this or any illness while anxious about money? The answer is Disability Insurance.

Did you know that treatment for postpartum depression is covered under disability insurance? Had I not grown up in this business, I most likely wouldn’t have known. A policy will provide you with a portion of your income for this and all other mental illness for up to 2 years.

While there is definitely a movement surrounding mental illness right now and removing the stigma, there is so much work to be done. Celebrities, someone at work, a neighbor, a family member, it doesn’t matter. Mental illness can effect anyone at any time. Let’s be more open and compassionate so that those that suffer will speak up and get the help and support they need.

Thank you for reading.

Melody I. Herman

Insurance Specialties, Inc. & Pine Street Insurance

Broker specializing in Disability Insurance, Holistic Agent

melodyherman@insurance-specialties.com 

Join us for Health Insurance Awareness Day!

Due to the recent spate of inclement weather, the originally scheduled date of Thursday, February 19th has been changed to Tuesday, March 10th. Asheville Mayor Esther Manheimer, members of City Council, Buncombe County Officials, and citizens of North Carolina have been invited to participate in a community gathering to celebrate Health Insurance Awareness Day. The event will take place from noon to 1:30 P.M. at the Dr. Wesley Grant, Sr. Southside Center located at 285 Livingston Street (next to Fire Station #2), Asheville, NC 28801. Members of Western North Carolina Association of Health Underwriters will help educate the community at large regarding the vital role of the health insurance agent. It is essential that consumers fully understand that other insurance exists beyond The Affordable Care Act.  Our members are all licensed health insurance professionals whose careers are based on helping consumers with health insurance issues. Western North Carolina Association of Health Underwriters is the Regional arm of the North Carolina Association of Health Underwriters which belongs to the National Association of Health Underwriters headquartered in Washington, DC.

Light refreshments will be available.

For further information, please contact:

Andrea Block, WNCAHU Media Chair

828.667.1119