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Ccsnys Dental Presentation

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  • Hello,

    My name is Rahul and I am from the Free Discount Plan for health care called Healthsouk.com.
    I am a health care enthusiast and work in P.R. for HealthSouk. I was wondering if you would be interested in interviewing our CEO - Dr. Neilesh Patel DDS regarding this innovative dental discount plan for a possible story or blog story. Our insurance plan with no monthly fees also is getting ready for launch in a just a couple months! It is a large wave in what is being called Consumer directed insurance plans. This is the wave of American health insurance for the next 10 years.

    Dr. Patel has started 3 previous startups that have brought access to health care to millions of people worldwide including HealthCare Volunteer (www.healthcarevolunteer.org) which he started as a dental student with $250 of his school loan money. Since then millions have received free health care around the world. HealthSouk is a new venture and this is the first of its kind and it has no monthly fees for patients. You can read more about him at www.drneileshpatel.com

    For patients HealthSouk has reinvented the wheel. . . No monthly fees. It puts the patient’s back in charge of their health care decisions and financing in an expedia or travelocity like manner.

    Marv Migdol who is the CEO of Consumer Health Alliance recently made a quote about HealthSouk saying he was “impressed with our background and achievements”. Marv is one of the fathers of the discount plan industry and got involved with decades ago.

    This is a difficult time for patients to get access to discount dental services and our service grew from 1000 members last month to almost 10,000 in a just couple weeks. I look forward to hearing from you soon and working with you to setup an interview with Dr. Patel

    Sincerely,
    Rahul
    Public Relations - HealthSouk.com
    www.healthsouk.com
    administrator@healthsouk.com
    310-928-3611
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Ccsnys Dental Presentation

  1. 1. DENTAL INSURANCE PROGRAMS FOR MEMBER AGENCIES OF CCSNYS Presented by: Jenny Sardi Benefits Specialist, Council Services Plus, Inc.
  2. 2. Programs Available <ul><li>Dental PPO (Preferred Provider Plan) offered through CCSNYS’ Delta Dental PPO Plan </li></ul><ul><ul><li>A traditional dental insurance plan with your choice of Dentists. </li></ul></ul><ul><li>Delta Dental DentalCare </li></ul><ul><ul><li>Designed similar to an HMO, you must choose a network dentist. </li></ul></ul><ul><ul><li>Prepaid Dental Plan. </li></ul></ul>
  3. 3. <ul><li>CCSNYS Group Number 1431 </li></ul>Delta Dental Preferred Plan
  4. 4. Delta Preferred Plan <ul><li>Eligibility- </li></ul><ul><ul><li>Any Member Agency of CCSNYS that has been a member for at least 60 days may enroll in the PPO Dental on the first of any month after signing a group contract with CCSNYS </li></ul></ul><ul><ul><li>50% of eligible employees must enroll in the Dental Plan. </li></ul></ul><ul><ul><ul><li>Eligible employees must work a minimum of 20 hours a week </li></ul></ul></ul><ul><ul><ul><li>Employees who do not elect coverage because they have Dental through another source are counted toward the 50% eligibility. </li></ul></ul></ul>
  5. 5. DeltaPreferred Plan <ul><li>Plan covers: </li></ul><ul><li>Dental Services Paid by Delta </li></ul><ul><li>Diagnostic 90% </li></ul><ul><li>Preventive 90% </li></ul><ul><li>Basic Restorative 80% </li></ul><ul><li>Oral Surgery 70% </li></ul><ul><li>Endodontic 70% </li></ul><ul><li>Periodontic 50% </li></ul><ul><li>Major Restorative 50% </li></ul><ul><li>Orthodontics 50% </li></ul><ul><li>TMJ 50% </li></ul><ul><li>Maximums : $2000 per person per calendar year. </li></ul><ul><li>Orthodontics has a separate maximum of $1250 lifetime per patient. </li></ul><ul><li>Deductible : $50 per person per calendar year. Maximum of $150 per family per calendar year. Does not apply to Diagnostic and Preventative care. </li></ul>
  6. 6. Delta Preferred Plan <ul><li>Covered Benefits: </li></ul><ul><li>Diagnostic: Procedures to assist dentists to evaluate existing conditions and dental care required - to include visits, exams, diagnosis and x-rays (exams & bitewing x-rays are benefits twice in any twelve month period. </li></ul><ul><li>Preventive: Prophylaxis (cleaning is a benefit twice in any twelve month period), fluoride treatments (limited to age 19), space maintainers, sealant (to age 14, once in every 36 months on unfilled permanent first and second molars). </li></ul><ul><li>Basic Restorative: Amalgam and composite fillings. </li></ul><ul><li>Major Restorative: Crowns, inlays, onlays are benefited where above materials are not adequate. </li></ul><ul><li>Oral Surgery: Extraction and oral surgery procedures including pre- and post-operative care. </li></ul><ul><li>Endodontics: Procedures for pulpal therapy and root canal filling. </li></ul><ul><li>Periodontal: Surgical and non-surgical procedures for treatment of gums and supporting structures of teeth. </li></ul><ul><li>Orthodontics: Procedures for straightening teeth (orthodontics is a benefit for dependent children to age 19). </li></ul><ul><li>TMJ: Reversible procedures for treatment of temporomandibular joint dysfunction. </li></ul>
  7. 7. Delta Preferred Plan <ul><li>Participants can go to see any dentist, but receive the best rates from Delta Preferred Plan Dentist. </li></ul>Preferred Dentist Premier Dentist Non Delta Dentist Dentist Bill $180.00 $180.00 $180.00 Dentist Accepts $90.00 (agreed on fee) $130.00 (agreed on fee) $180 .00 (no fee agreement) Delta Payment $81.00 $81.00 $81.00 Patient Share $9.00 $49.00 $99.00 Patient Savings $90.00 $60.00 $0
  8. 8. DeltaPreferred Plan <ul><li>To view a list of providers in your area go to www.deltadental.com then: </li></ul><ul><ul><li>Choose New York </li></ul></ul><ul><ul><li>Click on “Dental Search” under the heading “Looking for a Dentist” </li></ul></ul><ul><ul><li>Under “Product Selection,” chose the Delta Dental PPO plan </li></ul></ul><ul><ul><li>Complete the demographic information to get a list of dentists. </li></ul></ul>
  9. 9. Delta Preferred Plan <ul><li>The rates </li></ul><ul><ul><li>Individual- $31.36 per month </li></ul></ul><ul><ul><li>Individual + One- 81.22 per month </li></ul></ul><ul><ul><li>Family- $104.40 per month </li></ul></ul>
  10. 10. <ul><li>CCSNYS Group Plan 1721 </li></ul>Delta Dental DeltaCare Plan
  11. 11. Delta Dental DeltaCare <ul><li>Eligibility </li></ul><ul><li>Active members of CCSNYS may enroll in the DeltaCare Plan on the first of the month after signing a contract with CCSNYS. </li></ul><ul><li>Eligible employees must work a minimum of 20 hours a week. </li></ul><ul><li>Participation </li></ul><ul><li>There is no participation requirements for this plan. </li></ul><ul><ul><li>As few as one employee can enroll for coverage </li></ul></ul><ul><ul><li>Coverage is even available to members with only one employee </li></ul></ul>
  12. 12. Delta Dental DeltaCare <ul><li>Services Covered by the plan include: </li></ul><ul><ul><ul><li>Diagnostic – covered in full </li></ul></ul></ul><ul><ul><ul><li>Preventive – covered in full </li></ul></ul></ul><ul><ul><ul><li>Restorative – some procedures are covered in full </li></ul></ul></ul><ul><ul><ul><li>Endodontic </li></ul></ul></ul><ul><ul><ul><li>Periodontal </li></ul></ul></ul><ul><ul><ul><li>Prosthodontics </li></ul></ul></ul><ul><ul><ul><li>Orthodontics – copay of $180o for most adolescents. </li></ul></ul></ul><ul><li>There are no Maximums or Deductibles </li></ul><ul><li>A full listing of co-pays are available from CCSNYS </li></ul>
  13. 13. Delta Dental DeltaCare <ul><li>DeltaCare Coverage is based on the HMO model </li></ul><ul><li>Each service performed has an associated co-pay that is payable to the dentist at the time of service. </li></ul><ul><li>Diagnostic, preventative and some basic restorative procedures are covered in full by this plan. </li></ul>
  14. 14. Delta Dental DeltaCare <ul><li>Participants must choose a dentist from the DeltaCare directory. </li></ul><ul><li>To view a list of providers in your area go to www.deltadental.com and: </li></ul><ul><ul><li>Choose New York </li></ul></ul><ul><ul><li>Click on “Dental Search” under the heading “Looking for a Dentist” </li></ul></ul><ul><ul><li>Under “Product Selection,” choose the “DeltaCare USA” </li></ul></ul><ul><ul><li>Complete the demographic information to get a list of dentists. </li></ul></ul>
  15. 15. Delta Dental DeltaCare <ul><li>The rates </li></ul><ul><ul><li>Individual - $30.10 </li></ul></ul><ul><ul><li>Individual plus One - $45.45 </li></ul></ul><ul><ul><li>Family - $62.42 </li></ul></ul>
  16. 16. Delta Dental DeltaCare <ul><li>Member Agencies may enroll in the DeltaCare program on the 1 st of the month following the receipt of a signed contract, providing the contract and enrollment forms are received by the 15 th of the month. </li></ul><ul><li>The DeltaCare program is a prepaid dental plan. DeltaCare pays a monthly fee to the primary care dentist listed on the enrollment form. Timeframes are strictly enforced by DeltaCare. </li></ul><ul><li>Termination forms must also be received by the 15 th of the month prior to the termination date. There are no retroactive terminations allowed. </li></ul>
  17. 17. <ul><li>CCSNYS Administered Insurance Programs </li></ul>Dental Program Administration
  18. 18. Administrative Highlights <ul><li>CCSNYS Provides All the Administration for the Dental Coverage </li></ul><ul><li>If you have the health or life insurance through the CCSNYS Plans, your Dental Insurance Premium will be billed on the same invoice as the health or dental (monthly invoices). </li></ul><ul><li>By having one administrator your service will be personalized. </li></ul><ul><li>You can add Dental Coverage at anytime throughout the year, and still maintain your January 1 renewal date. </li></ul><ul><li>CCSNYS provides all the enrollment material you need at the annual open enrollment meeting held each November. </li></ul><ul><li>Communication of any changes implemented by the carrier will be communicated to you from CCSNYS. </li></ul>
  19. 19. <ul><li>Questions?? </li></ul><ul><li>Who to call for applications and more info? </li></ul><ul><li>Jenny Sardi x 129 </li></ul><ul><li>[email_address] </li></ul><ul><li>Eric Laughlin x 128 </li></ul><ul><li>[email_address] </li></ul>Insurance Programs for Members of CCSNYS

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