Group benefits brokers are asked to help their group clients solve difficult employee benefits challenges. Brokers do a great a job helping protect their clients and employees, especially when they have the right employee benefits solutions. SecureCare provides the dental, vision, life and disability solutions brokers need to help solve employee benefits challenges.
Here's a look at an actual successful SecureCare multi-state, multi-national dental benefits solution.
Important Note: The Copay Plan is a fully-insured dental PPO MAC with no Annual Maximum. The Copay Plan is not a discount or DHMO plan.
As a result, The Copay Plan also uses SecureCare's National and Mexico Dental Network. Members are not assigned to a dental office and can see contracted provider in the U.S. and Mexico.
Client Challenge
The group, located in four (4) states, had five different dental plans, multiple premium bills and several enrollment processes. It was an enrollment, billing and benefits headache to enroll and administer.
In addition, the group's Spanish speaking employees needed a US-Mexico dental network to increase access to high-quality, Spanish speaking dental providers.
Prior to SecureCare, this employer group’s dental benefits included a PPO and four DHMOs; a different one for each of the four states where the employer was operating. Because DHMOs cannot cross state lines, the group's current benefits needed a different DHMO plan for the four states.
Simplified Benefits Solution
At the request of the group's broker, SecureCare provided a streamlined dental benefits solution with one enrollment platform, one premium bill and one premium payment and one point of contact.
The solution also improved the employees’ benefits. Instead of one PPO and four DHMOs, we installed two comprehensive dental insurance plans that improved coverage: The PPO Plan UCR and The Copay Plan (a PPO MAC).
US-Mexico Dentist Network
All employees enrolled with SecureCare automatically have access to the SecureCare US-Mexico Dental Network.
Employees on The PPO plans as well as, The Copay Plan have access to the U.S.-Mexico Dental Network.
Just like with our national network, employees who visit our contracted Mexico providers pay only their portion. The provider submits a claim to SecureCare for the remainder of allowed charges.
Because The Copay Plan is a fully-insured PPO plan, not a DHMO, The Copay Plan has a large state and national dentist network.
SecureCare's national network, through DenteMax, has nearly 270,000 access points.
No Annual Maximum
It is important to point out that one reason The Copay Plan is attractive to this group is that The Copay Plan has No Annual Maximum. The Copay Plan is unmatched as a fully-insured, PPO MAC dental plan with no annual maximum. It has no annual limit on services. It is also valuable to note again that The Copay Plan is not a DHMO.
One Plan Change Benefit
SecureCare has the “One Plan Change” benefit included with all plans and all members. This allows SecureCare members to change plans, off renewal, once a calendar year, from The PPO Plan to The Copay Plan or from The Copay Plan to The PPO Plan. No qualifying event is needed.
In practice this means that if a member on this group’s Prime UCR plan meets their annual maximum, the member could immediately change to The Copay Plan first of the following month with no annual maximum and finish all services needed without waiting. This gives all plan members a way to have no annual maximum.
UCR at the 90th Percentile
The PPO UCR plan the group selected pays at the 90th percentile of UCR.
This means that if a member happens to go to a dental provider who is not contracted, SecureCare will pay the claim according to what 90% of dentist are charging in the zip code area where the treating dentist is located.
Happy Client HR Team
The group and HR manager love the simplified plan designs; just two plans, easy enrollment, improved dental benefits and a single premium bill.
The broker doesn't receive urgent problem calls from the HR manager, because the plans work better for the employees and administration is streamlined.
The group and broker are also pleased that they could address concerns from their Spanish speaking employees through the SecureCare Mexico Dental Network.
We hope this Quick Case Study was valuable. If we can help you protect your clients with dental, vision, life and disability solutions, we look forward to talking.
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