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L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
About SDC
• Celebrating Over 27 Years
Providing Dental Benefits
• Developed, Owned and
Directed by Our Participating
Dentists
• Benefits Designed by Dental
Professionals
• Profits Held to Less Than 5%
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Superior Difference
• Network Contingency Reserve Fund
– Helps Offset Clients’ Actual Dental Utilization
– Shared Risk = Manageable Renewal Rates
• Superior Service
– Receptionist-Managed Phone System
– Calls Answered Within Three Rings
– 98% First Call Resolution
– Less Than 1% Claim Errors
• Contract Period Determined by Group
• No Waiting Periods
• No Missing Tooth Clauses
• No Balance Billing In Network
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Service Area
Serving
Ohio, Kentuc
ky, and
Indiana
Selling to Groups
Domiciled in
These States
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Nationwide Network
Nearly
8,500
Network
Access
Points!
SDC Can Grow
Our Network
Beyond Our
Service Area
to Meet
Membership
Demand!
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Plan Options
• The Preferred Plan
– Network-Driven Dental Plan
• The Direct Plan
– Dental Reimbursement Plan
The Preferred Plan
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
• Network-Driven Coverage
• 8,500 Network Access Points
(and Growing!)
• All specialties covered
Available Throughout All Counties In:
• Ohio
• Kentucky
• Indiana
Group Size:
• Minimum of Two
Enrolled Employees
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Preferred Plan
Features:
• Open Access – Client Determines In and Out of Network Coverage Levels
• Network-Only Option Available Upon Request
• Available Fully-Funded or Self-Funded
• Contributory, Voluntary, or Shared Employer/Employee
• Contract Period Determined by Group
• No Participation Requirements
• No Claim Forms or Balance Billing (in network)
• Unique Ortho Benefits – No Penalty for Prior Usage (Unless Group
Specifies)
• Co-Pays Available on Preventive Oral Evaluations (Determined by Group)
• Pediatric – Essential Health Benefits Available for Groups Under 50
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Direct Plan
• Dental Expense Reimbursement
• Dollar-Driven vs. Benefit-Driven
Available:
• Nationwide Without Network Option
• SDC Service Area With Preferred Network Option
Group Size:
• Minimum of 50 Eligible Employees
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
The Direct Plan
Features:
• No Network - See Any Dentist Nationwide
• Preferred Network Option Available for Even Greater Savings
• No List of Covered Services for Most Flexibility
• Add List of Covered Services for Greater Savings
• Self-Funded
• Contributory, Voluntary, or Shared Employer/Employee
• Contract Period Determined by Group
• Quick Reimbursement
No-Cost Extras
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Included At No Additional Cost With All Plans:
SMILERIDER
• 15% Discount on Cosmetic/Elective Dental Procedures Available
Through Participating Providers
EyeMed Vision Discount Plan
• Discount Card Offering 15-20% Average Savings on Vision Services and
Products – No Limit to Usage
ThinkHR Comply
• HR Compliance Resource Center Available Exclusively to Our Clients
Who Sign Up for Superior Direct Connect, Our Online Account
Management System – A Value Of $575
Buy-Up Option
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
COBRA
• Full Service COBRA Administration
• Available With Any SDC Plan
• Powered by Ceridian
Funding Options
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Fully-Funded
• Available on Preferred Plans
Self-Funded
• Administrative Services Only
• Available on Direct and Preferred Plans
Funding Options
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Fully-Funded
• Competitive Rates
• 3-5% Average Renewal Trend
• Underwritten Rates Available for 51+ Eligible Employees
• Community Rates Available for 50 or Less Eligible Employees
• Groups between 30-50 may select either the Community Rated
options or Individually Underwritten Options
Funding Options
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Self-Funded / Administrative Services Only (ASO)
• Minimum Group Size: 50 Eligible Employees
• Claims Savings Through Network
• Administration Fee Includes:
– Claims Administration
– Member Materials
(Including EOBs)
– ID Cards
– Reporting
– Full SDC Service
– Network Access
– No Initial Start-Up Cost
– SPDs Upon Request
(Additional Charge May Apply)
Group Categories
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Groups of 51+ Eligible Employees
• Customized Plan Designs
• Underwritten Rates
• LOCS: Standard, Adopt, Modify, Modify+
• Multi-Year Rate Guarantees May Be Granted
Groups of 50 or Less Eligible Employees
• Community-Rated Plans
• Set Options Available With Limited Customization
• Standard LOCS
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Requirements For Quote:
• Census of Eligible Employees, Zip Codes, Tier Structure,
Waivers and COBRA
• Current and Renewal Rates
• Current Carrier
• Current Plan Design
• Current LOCS (Any Required Matches)
• Employer Contribution
• Group’s Effective Date
• Due Date of RFQ
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
List of Covered Services (LOCS) Can Be Altered Per Group Size:
• Groups Over 100 Eligible Employees
– Adopt – Program Current Carrier’s LOCS In SDC System As-Is
– Modify – Move Services
– Modify+ – Move Services and/or Add/Alter Frequencies/Limitations
• Groups 51-100 Eligible Employees
– Modify – Move Services
– Modify+ – Move Services and/or Add/Alter Frequencies/Limitations
• Groups 30-50 Eligible Employees (If Individually Underwritten)
– Modify – Move Services
• Community-Rated Groups (50 or Less Eligible Employees)
– Standard LOCS
– No Exceptions Made
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Differences in LOCS to Look For:
• Services Commonly Found in Different Categories
(Preventive, Basic, Major, Ortho, or Class I, II, III, IV):
– Endodontics
– Periodontics
– Sealants
– Space Maintainers
• Trending Additions to LOCS:
– Dental Implants
– Extra Cleanings
Quoting SDC
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Network Reports Available Upon Request:
• GEO Access Report
– Prepared for Quotes of Groups Over 100
– Employee Zip Codes Required
• Disruption Report
– Prepared for Quotes of Groups Over 100
– Requirements:
• Provider Names
• Tax ID Number
• Provider zip codes
• Provider address (not required but helpful)
• # of Claims (not required but helpful)
• $ of Claims (not required but helpful)
Renewal Process
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Underwritten Groups (Any Size)
• Signed Addendum Required
• Renewal Addendum Emailed to Broker 90 Days in Advance of Renewal
• Follow-Up Sent to Broker 30 Days in Advance of Renewal
Community-Rated Groups (50 or Less)
• Renewal Emailed to Broker 60 Days in Advance of Renewal
• Community-Rated Plan Sheets Always Available on Website
– Rates Published in September for Upcoming Year
– Rates on Community-Rated Plan Sheets are Same For New & Renewing
Groups
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Account Management Team Structure:
• Manager of Account Sales – Oversees the Account Executives and the
Account Sales Team
• Account Executives (AE) – New Business and Renewals, Initial and
Renewal Employee Enrollment Presentations
• Manager of Account Services – Oversees the Account Coordinators and the
Accounts Services Team. Manages Accounts 500+ Enrolled Alongside the AE
for Additional Support and Representation for the Client and Broker.
• Account Coordinators (AC) – Process and Send Renewals, Manage
Service (Claims, Enrollment and Billing) Inquiries, Report Requests,
Membership Reports. Table Sits and Benefit/Health Fair Booth
Representation.
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Contact Structure:
• 500+ Enrolled: Account Executive Lead Contact, Manager of Account
Services Secondary Contact, Account Coordinator
Support…Complete Team of Account Management!
• 51-499 Enrolled and Underwritten Accounts: Account Executive
Lead Contact, Account Coordinator Secondary Contact
• 50 Enrolled or Less and All Community-Rated Plans: Account
Coordinator Lead Contact, Account Executive Secondary Contact
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Underwritten Groups - 51+ Eligible Employees:
• Account Executive (AE)
– First Contact Point for Day to Day Needs
– Available For:
• Enrollment Meetings (for groups 51+)
• Presentations
• Table Sits
• Account Coordinator (AC)
– Prepares and Delivers Renewal to Broker and AE
– Supports AE in Day to Day Needs
– Client Report Requests for Groups of 100+ Eligible Employees
Account Management
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Community-Rated Groups – 50 or Less Enrolled Employees:
• Dedicated Account Coordinator
– Day-to-Day Service Needs of Broker
– Prepares and Sends Renewal to Broker
– No Outside Service
• Self-Service Available Online (For All Group Sizes)
– Community-Rated Plans/Rates
– Group Application
– Employee Enrollment Form
– Direct Connect – Secure Account Management Portal
L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
Thank
You!
Questions?

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Superior Dental Care

  • 1. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S
  • 2. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S About SDC • Celebrating Over 27 Years Providing Dental Benefits • Developed, Owned and Directed by Our Participating Dentists • Benefits Designed by Dental Professionals • Profits Held to Less Than 5%
  • 3. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S The Superior Difference • Network Contingency Reserve Fund – Helps Offset Clients’ Actual Dental Utilization – Shared Risk = Manageable Renewal Rates • Superior Service – Receptionist-Managed Phone System – Calls Answered Within Three Rings – 98% First Call Resolution – Less Than 1% Claim Errors • Contract Period Determined by Group • No Waiting Periods • No Missing Tooth Clauses • No Balance Billing In Network
  • 4. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Service Area Serving Ohio, Kentuc ky, and Indiana Selling to Groups Domiciled in These States
  • 5. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Nationwide Network Nearly 8,500 Network Access Points! SDC Can Grow Our Network Beyond Our Service Area to Meet Membership Demand!
  • 6. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Plan Options • The Preferred Plan – Network-Driven Dental Plan • The Direct Plan – Dental Reimbursement Plan
  • 7. The Preferred Plan L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S • Network-Driven Coverage • 8,500 Network Access Points (and Growing!) • All specialties covered Available Throughout All Counties In: • Ohio • Kentucky • Indiana Group Size: • Minimum of Two Enrolled Employees
  • 8. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S The Preferred Plan Features: • Open Access – Client Determines In and Out of Network Coverage Levels • Network-Only Option Available Upon Request • Available Fully-Funded or Self-Funded • Contributory, Voluntary, or Shared Employer/Employee • Contract Period Determined by Group • No Participation Requirements • No Claim Forms or Balance Billing (in network) • Unique Ortho Benefits – No Penalty for Prior Usage (Unless Group Specifies) • Co-Pays Available on Preventive Oral Evaluations (Determined by Group) • Pediatric – Essential Health Benefits Available for Groups Under 50
  • 9. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S The Direct Plan • Dental Expense Reimbursement • Dollar-Driven vs. Benefit-Driven Available: • Nationwide Without Network Option • SDC Service Area With Preferred Network Option Group Size: • Minimum of 50 Eligible Employees
  • 10. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S The Direct Plan Features: • No Network - See Any Dentist Nationwide • Preferred Network Option Available for Even Greater Savings • No List of Covered Services for Most Flexibility • Add List of Covered Services for Greater Savings • Self-Funded • Contributory, Voluntary, or Shared Employer/Employee • Contract Period Determined by Group • Quick Reimbursement
  • 11. No-Cost Extras L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Included At No Additional Cost With All Plans: SMILERIDER • 15% Discount on Cosmetic/Elective Dental Procedures Available Through Participating Providers EyeMed Vision Discount Plan • Discount Card Offering 15-20% Average Savings on Vision Services and Products – No Limit to Usage ThinkHR Comply • HR Compliance Resource Center Available Exclusively to Our Clients Who Sign Up for Superior Direct Connect, Our Online Account Management System – A Value Of $575
  • 12. Buy-Up Option L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S COBRA • Full Service COBRA Administration • Available With Any SDC Plan • Powered by Ceridian
  • 13. Funding Options L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Fully-Funded • Available on Preferred Plans Self-Funded • Administrative Services Only • Available on Direct and Preferred Plans
  • 14. Funding Options L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Fully-Funded • Competitive Rates • 3-5% Average Renewal Trend • Underwritten Rates Available for 51+ Eligible Employees • Community Rates Available for 50 or Less Eligible Employees • Groups between 30-50 may select either the Community Rated options or Individually Underwritten Options
  • 15. Funding Options L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Self-Funded / Administrative Services Only (ASO) • Minimum Group Size: 50 Eligible Employees • Claims Savings Through Network • Administration Fee Includes: – Claims Administration – Member Materials (Including EOBs) – ID Cards – Reporting – Full SDC Service – Network Access – No Initial Start-Up Cost – SPDs Upon Request (Additional Charge May Apply)
  • 16. Group Categories L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Groups of 51+ Eligible Employees • Customized Plan Designs • Underwritten Rates • LOCS: Standard, Adopt, Modify, Modify+ • Multi-Year Rate Guarantees May Be Granted Groups of 50 or Less Eligible Employees • Community-Rated Plans • Set Options Available With Limited Customization • Standard LOCS
  • 17. Quoting SDC L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Requirements For Quote: • Census of Eligible Employees, Zip Codes, Tier Structure, Waivers and COBRA • Current and Renewal Rates • Current Carrier • Current Plan Design • Current LOCS (Any Required Matches) • Employer Contribution • Group’s Effective Date • Due Date of RFQ
  • 18. Quoting SDC L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S List of Covered Services (LOCS) Can Be Altered Per Group Size: • Groups Over 100 Eligible Employees – Adopt – Program Current Carrier’s LOCS In SDC System As-Is – Modify – Move Services – Modify+ – Move Services and/or Add/Alter Frequencies/Limitations • Groups 51-100 Eligible Employees – Modify – Move Services – Modify+ – Move Services and/or Add/Alter Frequencies/Limitations • Groups 30-50 Eligible Employees (If Individually Underwritten) – Modify – Move Services • Community-Rated Groups (50 or Less Eligible Employees) – Standard LOCS – No Exceptions Made
  • 19. Quoting SDC L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Differences in LOCS to Look For: • Services Commonly Found in Different Categories (Preventive, Basic, Major, Ortho, or Class I, II, III, IV): – Endodontics – Periodontics – Sealants – Space Maintainers • Trending Additions to LOCS: – Dental Implants – Extra Cleanings
  • 20. Quoting SDC L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Network Reports Available Upon Request: • GEO Access Report – Prepared for Quotes of Groups Over 100 – Employee Zip Codes Required • Disruption Report – Prepared for Quotes of Groups Over 100 – Requirements: • Provider Names • Tax ID Number • Provider zip codes • Provider address (not required but helpful) • # of Claims (not required but helpful) • $ of Claims (not required but helpful)
  • 21. Renewal Process L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Underwritten Groups (Any Size) • Signed Addendum Required • Renewal Addendum Emailed to Broker 90 Days in Advance of Renewal • Follow-Up Sent to Broker 30 Days in Advance of Renewal Community-Rated Groups (50 or Less) • Renewal Emailed to Broker 60 Days in Advance of Renewal • Community-Rated Plan Sheets Always Available on Website – Rates Published in September for Upcoming Year – Rates on Community-Rated Plan Sheets are Same For New & Renewing Groups
  • 22. Account Management L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Account Management Team Structure: • Manager of Account Sales – Oversees the Account Executives and the Account Sales Team • Account Executives (AE) – New Business and Renewals, Initial and Renewal Employee Enrollment Presentations • Manager of Account Services – Oversees the Account Coordinators and the Accounts Services Team. Manages Accounts 500+ Enrolled Alongside the AE for Additional Support and Representation for the Client and Broker. • Account Coordinators (AC) – Process and Send Renewals, Manage Service (Claims, Enrollment and Billing) Inquiries, Report Requests, Membership Reports. Table Sits and Benefit/Health Fair Booth Representation.
  • 23. Account Management L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Contact Structure: • 500+ Enrolled: Account Executive Lead Contact, Manager of Account Services Secondary Contact, Account Coordinator Support…Complete Team of Account Management! • 51-499 Enrolled and Underwritten Accounts: Account Executive Lead Contact, Account Coordinator Secondary Contact • 50 Enrolled or Less and All Community-Rated Plans: Account Coordinator Lead Contact, Account Executive Secondary Contact
  • 24. Account Management L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Underwritten Groups - 51+ Eligible Employees: • Account Executive (AE) – First Contact Point for Day to Day Needs – Available For: • Enrollment Meetings (for groups 51+) • Presentations • Table Sits • Account Coordinator (AC) – Prepares and Delivers Renewal to Broker and AE – Supports AE in Day to Day Needs – Client Report Requests for Groups of 100+ Eligible Employees
  • 25. Account Management L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Community-Rated Groups – 50 or Less Enrolled Employees: • Dedicated Account Coordinator – Day-to-Day Service Needs of Broker – Prepares and Sends Renewal to Broker – No Outside Service • Self-Service Available Online (For All Group Sizes) – Community-Rated Plans/Rates – Group Application – Employee Enrollment Form – Direct Connect – Secure Account Management Portal
  • 26. L E A D I N G T H E W A Y I N D E N T A L B E N E F I T S Thank You! Questions?