[ ] DentalVision03.ppt
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[ ] DentalVision03.ppt Presentation Transcript

  • 1. Update on Dental & Vision October 17, 2002
  • 2. Options
    • Current Plan – Ameritas
      • Proposals were received from: Ameritas, United, Paragon, Shenandoah, Delta
      • United and Shenandoah and Delta too high
      • Paragon (www.paragondental.com) & Ameritas remain
  • 3. Current Plan vs. Paragon *College Cost=$9.64 ** College Cost=$10.28 ***College Cost=$9.50 $55.44 $35.52 $35.96 $16.04 Ameritas Renewal High Plan $27.24 $17.48 $9.76 $0.00** Ameritas Renewal Low Plan $55.50 $40.10 $28.90 $12.00 Paragon Pref PPO $72.50 $44.42 $36.50 $16.75 Paragon Select Indemnity $33.54 $9.25 $ 9.12 EE + SP $51.88 $24.80 $25.48 Family $33.24 $15.60 $16.36 EE +CH $15.00 $0.00*** $0.00* Single Current Ameritas High Plan Paragon Premium Plan-HMO Current Ameritas Low Plan
  • 4. Plan Design Comparisons Link to Full Comparison & Providers on DMO 40% Cost Set fee amount paid (small) Major Yes No Vision Discounts Included Cleanings, exams, x rays Cleanings and exams Preventative Fillings, steel crowns, Perio, root X-rays, fillings, oral surgery Basic Por crowns, inlays, dentures, bridges Endo, root canal, perio crowns Major 100% amalgam, 50% Cost all other 100% Cost 25% discount 280-All None None None Yes 28 Orange, 4 Brevard, 16 Seminole Set fee amount paid (small) Basic 100% UCR Preventative None Orthodontics 181 # ADA Procedures Covered Yes Limitations & Exclusions $1,000 Maximum Benefit $75 waived for prev Deductible per person per year No-If network provider used then out of pocket costs are reduced Providers Must Be In Network Paragon Premium DMO Ameritas Low Plan
  • 5. Ameritas High vs Paragon Pref PPO Link to Preferred Providers List 50%/ 35% UCR 50% UCR Major Yes No Vision Discounts Included 80%/ 50% UCR 100% / 100% UCR 25% discount Porcelain crowns, inlays, dentures, bridges Fillings, steel crowns, Perio, root canal Cleanings, exams, x rays $1,000 $50 waived-prev& diag No- If network provider used then out of pocket costs are reduced 31 Orange, 4 Brevard, 16 Seminole Cleanings and exams Preventative X-Rays, Fillings, oral surgery Basic Endo, root canal, perio crowns Major 80% UCR Basic 100% UCR Preventative None Orthodontics $1,000 Maximum Benefit $75 waived for prev Deductible/person/ year No- If network provider used then out of pocket costs are reduced Providers Must Be In Network Paragon Preferred PPO Ameritas High Plan
  • 6. Ameritas High vs Paragon Select No No Vision Discounts Included 6 months for ee’s with no prior coverage None Waiting Periods- Major Procedures 50% UCR 50% UCR Major Cleanings, exams, x rays Cleanings and exams Preventative Fillings, steel crowns, root canal X-Rays, fillings, oral surgery Basic Endo, Perio, porcelain crowns, inlays, dentures, bridges Endo, root canal, perio crowns Major 80% UCR 100% UCR 25% discount $1,000 $75/$225 waived-prev Any dentist 80% UCR Basic 100% UCR Preventative None Orthodontics $1,000 Maximum Benefit $75 waived for prev Deductible per person per year No- If network provider used then out of pocket costs are reduced Providers Must Be In Network Paragon Select Ind Ameritas High Plan
  • 7. Out of Pocket Comparison of Paragon Plans
  • 8. Vision Discounts on Paragon Dental Premium and Preferred Plans Present your ID card or Member ID number to a Participating Provider and you realize a significant savings without the hassle of claims and co-payments. Below is a brief description of the benefits available under the Discount Vision program: Your Discount Vision Benefits The Discount Vision Pricing Routine Vision Examination 80% of UCR not to exceed $45 Standard Single Vision Lenses $35 Standard Bifocal Lenses $50 Standard Trifocal Lenses $65 Standard Progressive Lenses $105 Frames Wholesale** + 40% ** As recognized by FRAMES Magazine, a publication distributed to eyewear dispensing locations nationwide Contact Lenses Wholesale pricing on contact lenses + Professional Fitting fees Additional Lens Options 20-60% savings according to Avesis fixed discounted fees
  • 9. Vision Discounts on Paragon Dental Premium and Preferred Plans Below is an example of The Paragon Discount Vision pricing. To find a Participating Vision Provider in your area www.paragondental.com.   *** Your average savings realized may be more or less depending on your choice of frames and lenses. Discount Vision Benefit Utilized Average Retail Price Discount Vision Price Savings Realized*** Routine Exam $60.00 $40.00 $20.00 Standard Single Vision Lenses $69.00 $35.00 $34.00 Frame (Fossil brand, Pluto style) $150.00 $70.00 $80.00   TOTAL: $279.00      TOTAL: $145.00 TOTAL: $134.00***
  • 10. Current Plan vs. 20/20 ( www.2020eyecareplan.com) $10.38 N/A 2 Person $17.10 $18.60 Family $5.75 $6.50 Single 20/20 Plan Current Vision Care Plan
  • 11. Vision Benefits Comparison 20/20 Providers in Florida *Providers can be successfully recruited prior to effective date N/A discounts discounts Lasik Surgery 22 Brevard, 29 Orange, 11 Seminole 22 Brevard, 29 Orange, 11 Seminole 37 Brevard, 96 Orange, 44 Seminole Providers $119 allowance(not include exam) 100% after $10-$85 copay $10.00 $4.00 12/12/12/12 $105 allowance (includes exam) 100% within frame allowance $15.00 $10.00 12/12/24/12 50% discount 60% discount $35.00-$65.00 $45.00 With Preferred PPO Dental Contact Allowance Frame Coverage Lense Co-Pay Exam Co-Pay In Network Frequency Exam/Lenses/Frames/Cont W/DMO & Pref PPO Dental 20/20 Current Vision
  • 12. FEEDBACK/QUESTIONS