Today I’m here to talk to you about SunStar Dental’s Dental Direct. It is a truly unique program that we developed as an alternative to dental insurance. - We worked with the American Dental Association to create the concept and it is similar to a program they developed called “Direct Reimbursement”. - The idea is to spend money on dental care only when you need it. - Unlike Dental Insurance where you pay premiums on a regular basis for coverage you may never use all money in SunStar’s Dental Direct goes directly to cover the cost of dental care.
This page is provided for you to take notes, if you like.
-There are some good reasons to offer dental benefits. -TO ATTRACT AND RETAIN TALENTED EMPLOYEES. - Often employees look for more than just a salary. -TO REDUCE EMPLOYEE ABSENCES AND POOR PERFORMANCE DUE TO CONSTANT DENTAL PAIN. - There are times when individuals are in pain, but because they don’t have dental coverage they don’t go to the dentist. They suffer and work performance is negatively impacted. -TO TAX ADVANTAGE. - HSA alternative.
INSURANCE – Insurance is based on a pooling of individuals monies to share risk. Some individuals will receive more than what they pay in premiums, but the majority will receive less. In some cases 100% of what is paid in is never used. - We want to clarify this works for dental insurance. We would not necessarily recommend this for medical insurance. Although some large companies do what is known as “self-insure”. - We recently had an individual that came in. He had paid for dental insurance for 17 years and he had never been to the dentist. Now we would never say not to go to the dentist for 17 years, but if you look at this scenario the individual had paid thousands of dollars for coverage he never used . - In a recent study by the American Dental Association it found that 80% of the individuals covered by dental insurance do not use it in any given year. THIS IS A MAJOR WASTE OF MONEY FOR COMPANIES. We would never say not to have medical coverage, but if you look at dental coverage there are a number of limitations. Dental Insurance is generally broken down into 3 areas: - PREVENTATIVE – which would include cleanings and exams. Generally covered at 100% and generally have no deductible. Cost if paid out of pocket would be between $150-$200 and should be done twice a year. - BASIC – includes things like And generally has a deductible - MAJOR – which includes things like And generally has a deductible. Sometime as high as $150. Which means the individual has to pay before any coverage happens by the insurance company. f -DEDUCTIBLES – Are amounts you must pay first before the insurance company pays anything. -MAXIMUMS – Are set limits, often $1000-$1500. -Catastrophic vs. minor coverage – HSA example. -INSURANCE COMPANIES EXIST TO MAKE MONEY. -- Look at the skyline of any city and you will see many of the buildings are owned by insurance companies.
THE BIGGEST PROBLEM WITH DENTAL INSURANCE IS THEY PAY THE SAME FEES NO MATTER WHICH DENTIST YOU GO TO IN AN AREA. There is no measure of quality of care. - So regardless of the quality of care a dentist provides they are reimbursed the same. So a high quality dentist that uses US labs that have high quality is reimburse the same as a dentist that uses labs from a third world country even thought the cost of inferior materials can be as low as 1/10 th a US lab. Quality is the key, but insurance companies focus on cost not quality. -INDEMNITY – Let’s you pick any dentist and covers most fees up to a maximum or percentage. Sometimes based on ages, locations (zip code). -PPO – “In Network” vs. “Out of Network”. - In Network is where the insurance company promises to bring a dentist a volume of patients in return for the dentist agreeing to lower-fees. - There is a lot of turnover in this area since the volume of patients never make the numbers dentists expect. - Fees are not differentiated as to the skills of the dentist. All are paid the same rate whether 20 years of experience and a master in the field of a student right out of school with minimal skills. SO WHAT YOU OFTEN SEE IS NEWER DENTISTS SIGNING UP FOR THIS UNTIL THEY BUILD A PATIENT BASE AND THEN THEY DROP THE PLAN. - Out of Network is where a patient can see any dentist and fees are cover up to a certain amount. - Insurance companies often do not share what this amount is, because they fear dentists will charge the maximum in all cases. - Often they link this to co-pay amounts. - Most dentists will work as “Out of Network”. -HMO – Set fees, dentists are paid a monthly amount based on the number of patients signed up whether they ever see the patient or not. - Strategy is to sign up as many patients as possible and never see them. - Quality of dental care in this environment has often been questioned (low cost materials, set time limits, multiple visits). - Insurance companies liked this model – It made it easy to tell what profits would be. - This model has lost favor over the years. -DISCOUNT PLANS – are not really insurance. What they try to do is get dentists to offer some services at a discount for being part of a plan. Often other services are charged at a higher rate to make up for the lower cost on the discounted items. Also the quality has come into question. -SUNSTAR DENTAL’S DENTAL DIRECT – A custom plan based on your organizations needs. No money is spent on insurance, all money goes for dental care.
Six Months + 1 day.
OPTION 1 -YOUR COMPANY IS BILLED FOR THE REMAINDER. OPTION 2 -All tracking is done at your location directly.
Dr. Monica – Has been in practice almost 15 years. She attended Loyola, Marquette, and Northwestern Universities. - She started working in a dental office in high school and has worked her way up from front desk to assistant to hygienist and now to DR. - She opened her practice in 1995 – with a focus on the patient comfort . Dr. Marie – Has been in practice over 20 years. She attended Loyola University’s Dental School. - She practiced down the street in River Grove for 20 years before joining Dr. Monica at their current location. They both take a number of hours of continuing education every year. The team consists of assistants, patient relationship coordinators. Their focus is to make it easier for patients to be with us. TECHONOLOGY is the newest. Examples – Over 2000 patients have made SunStar Dental their Dental office of choice – Many of them like us live in the community. -We differentiate ourselves by our quality and care. We are not a department store dental office or a North Shore operation, WE ARE A COMMUNITY BASED PRACTICE. -We plan on being here for the next 20 years. -You will see the same doctor each time. You will get to know them, they will get to know you. BUT MOST IMPORTANT IS OUR PATIENTS AND TREATING THEM RIGHT.
-DETERMINE WHICH EMPLOYEES ARE ELIGIBLE. -Are family members eligible.
-ARE ANY TYPE OF COSMETIC PROCEDURES COVERED. - This can sometimes be an issue. Most insurance companies do not cover this and probably more important the IRS does not allow tax deductions on cosmetic procedures, but it is up to you.
Sun Star Dental Alternative To Dental Insurance
SunStar Dental’s Dental Direct George Vukotich, Ph.D. The Small Business Alternative to Dental Insurance
SunStar Dental -- Family Dentistry 7765 W. North Avenue River Forest, IL 60305 708-771-8101 www.sunstardental.com Notes: SunStar Dental
Why Should an Employer Offer Dental Benefits <ul><li>To attract and retain talented employees. </li></ul><ul><li>To reduce employee absences and poor performance due to constant dental pain. </li></ul><ul><li>To take advantage of tax benefits. </li></ul>
Insurance <ul><ul><li>Preventative </li></ul></ul><ul><ul><li>Basic </li></ul></ul><ul><ul><li>Major </li></ul></ul><ul><li>Deductibles </li></ul><ul><li>Maximums </li></ul><ul><li>Companies/Individuals pay fees/premiums in return for coverage. </li></ul><ul><li>Dental Coverage is generally broken down into three areas: </li></ul>
Types of Insurance <ul><li>Indemnity </li></ul><ul><li>PPO </li></ul><ul><li>HMO </li></ul><ul><li>Discount Plans – Not Insurance </li></ul><ul><li>SunStar Dental’s Dental Direct – Not Insurance </li></ul>
Why SunStar Dental’s Dental Direct <ul><li>No insurance company to deal with. </li></ul><ul><li>It’s all about care – not about insurance. </li></ul><ul><li>No premiums to pay. </li></ul><ul><li>No unnecessary administrative expenses. </li></ul><ul><li>No claim forms to file. </li></ul><ul><li>No wasted hours on the phone. </li></ul><ul><li>No frustration dealing with vague policy terms. </li></ul><ul><li>No long waiting periods to get your money. </li></ul><ul><li>No surprises in what is and what is not covered. </li></ul>YOU DECIDE ALL FEATURES AND BENEFITS
How it Works Three simple steps get you started <ul><li>SunStar Dental registers the employees you identify in our system. </li></ul><ul><li>They are linked to your specific company and the benefit coverage you select. </li></ul><ul><li>Option 1: </li></ul><ul><li>Individuals come in for treatment and pay their share at the time of service. </li></ul><ul><li>Your company is billed for the remainder. </li></ul><ul><li>Option 2: </li></ul><ul><li>Individuals come in for treatment and pay the entire amount at the time of service and submit the bill to you. </li></ul><ul><li>You reimburse them for their share directly. </li></ul><ul><li>All money goes for dental coverage. </li></ul>
An Example <ul><ul><li>ADA studies show that over 80% of individuals never use their dental benefits to the maximum in any given year… </li></ul></ul><ul><li>A organization of 28 individuals was paying an average of $60 per month/individual for PPO dental coverage. </li></ul><ul><li>The company paid half the premium and the employee paid the other half. </li></ul><ul><li>This came out to a cost of $720 in premiums per individual. </li></ul><ul><li>In return for the $720 an individual received two cleanings per year (value between $300 and $400). Considered preventative coverage. </li></ul><ul><li>For other categories there was a $100 deductible before coverage started. So per individual the cost was $820. In return each individual would receive a maximum of $1000 coverage. </li></ul><ul><li>If an individual only needed cleanings they would over pay by more than 100%. If they went over a $1000 in coverage they would have to pay that amount themselves. </li></ul><ul><ul><li>The plan would only work to the advantage of those that need dental work over the premiums, but under the maximum. </li></ul></ul>
Questions to Ask <ul><li>In the past how much have I spent on Dental Insurance vs. Dental Care Expenses? </li></ul><ul><li>Have I had major expenses in any one year and not in others? </li></ul><ul><li>What amount do I want to cover per employee? </li></ul>
The SunStar Difference Your Community Dental Practice <ul><li>Our Doctors </li></ul><ul><ul><li>Education </li></ul></ul><ul><ul><li>Experience </li></ul></ul><ul><li>Our Team </li></ul><ul><ul><li>Commitment </li></ul></ul><ul><ul><li>History </li></ul></ul><ul><ul><li>Community </li></ul></ul><ul><li>Our Technology </li></ul><ul><ul><li>Capability </li></ul></ul><ul><li>. . . . . But most of all your needs . </li></ul><ul><ul><ul><ul><li>Our Relationship with you is key. </li></ul></ul></ul></ul>
Steps to Get Started <ul><li>Determine which employees are eligible (Also if family members are eligible). </li></ul><ul><li>Determine what if any deductible. </li></ul><ul><li>Determine what percentage owner/employee contribute. </li></ul><ul><li>Determine yearly maximum. </li></ul>
Next Steps Get the Word Out <ul><li>Let us know what parameters you would like. It’s your plan you decide what is best. </li></ul><ul><li>Talk to your employees. </li></ul><ul><li>Let them know what is available and how it works (or have us in and we will be happy to. </li></ul><ul><li>Have them stop by to meet the team and take a tour. </li></ul>Look at the options that best meet your needs. No need to waste money on dental insurance.
Lessons Learned <ul><li>Make contact to notify SunStar when an individual is no longer with the company. </li></ul><ul><li>Expectations: Let individuals know what the parameters are. SunStar can create a summary page. </li></ul><ul><li>Determine whether any type of Cosmetic Procedures be covered. </li></ul>
For More Information <ul><li>SunStar Dental -- Family Dentistry </li></ul><ul><li>7765 W. North Ave. </li></ul><ul><li>River Forest, IL 60305 </li></ul><ul><li>708-771-8101 </li></ul><ul><li>www.sunstardental.com </li></ul>Monica Reyna-Vukotich D.D.S. Marie T. Walsh, D.D.S. George Vukotich, Ph.D.