Articles
Benefits Managers Give Delta Dental High Marks
Get Current News from Delta Dental - Subscribe to Free Online Consultant News
Delta Dental Receives 'AA-' Rating From Standard & Poor's for Fifth Consecutive Year
Cost Containment Report Released
Golf Outing Raises $62,000 for Special Olympics
What Do You Get When You Call Customer Service? A Friendly Voice, Empathy and Answers
Lessons in Home Improvement - Will Evidenced-Based Dentistry Improve the Management of Dental Benefit Plans?
Staff Spotlight: Pat Barton

Benefits Managers Give Delta Dental High Marks

We are pleased to report that Delta Dental continues to receive high overall ratings from benefits managers.  In the 2004 Benefits Managers' Satisfaction Survey, nearly 9 in 10 benefits managers reported being "extremely satisfied" or "very satisfied" with Delta Dental. Ninety-five percent would recommend Delta Dental to other administrators.

Brownstone Information Resources, Inc., an independent market research firm in Morristown, New Jersey, conducted telephone interviews with 250 benefits managers selected at random in August.

How benefits managers rated our performance in 2004
Percentage who are "Extremely" or "Very Satisfied" with Delta Dental -86%
Percentage who would recommend Delta Dental to other administrators - 95%
Percentage who said Delta Dental performs "extremely" or "very well" at processing claims accurately - 82%
Percentage who said Delta Dental performs "extremely" or "very well" at processing claims quickly - 81%
Percentage who said Delta Dental performs "extremely" or "very well" at allowing employees/members choose their own dentist - 80%
Percentage who said Delta Dental performs "extremely" or "very well" at having Customer Service agents who are knowledgeable - 76%
Percentage who said Delta Dental performs "extremely" or "very well" at having Customer Service agents who are courteous/pleasant/empathetic - 79%
Percentage who said Delta Dental performs "extremely" or "very well" at processing eligibility changes, additions, deletions accurately - 84%
Percentage who said Delta Dental performs "extremely" or "very well" at processing eligibility changes, additions, deletions quickly - 83%

Additional findings:

• More benefits managers than ever have Internet access at work. Two years ago, 80% used the Internet at work; today it's up to 90%. Nearly two-thirds know that they can report eligibility changes, additions and terminations online.
• Benefits managers believe employees are also satisfied with Delta Dental. Three-quarters said their employees are "extremely" or "very happy" overall.
• Most benefits managers spend less than one hour per week assisting employees with Delta Dental claims or problems. Nearly 90% spend less than one hour a week assisting employees with Delta Dental issues. More than 9 in 10 said this was about the right amount of time or less time than expected.

The mission of Delta Dental Plan of New Jersey is "to promote oral health to the greatest number of people by providing accessible dental benefit programs of the highest quality, service, and value." The annual survey helps ensure that we continue to serve our customers to the high standards set by our mission.

Get Current News from Delta Dental - Subscribe to Free Online Consultant News

Delta Dental recently launched a bimonthly online publication for brokers and consultants called Consultant News. We developed it in order to provide more frequent, timely information to our brokers and consultants. 

Consultant News is published every other month. Beginning in 2005, the print version of Broker News will be published twice a year instead of quarterly.

Putting a greater focus on the online publication enables us to continue keeping you informed about Delta Dental's programs and products, while helping us reduce costs. As reported elsewhere in this issue, our cost containment efforts in 2003 saved groups more than $164 million. Cost containment is an important benefit of the Delta Dental program. We constantly look for ways to provide the greatest value for each group's benefit dollar.

Each bimonthly issue of Consultant News contains information about Delta Dental's products and services, including what sets Delta Dental apart from other dental benefits providers. A subscription to Consultant News is available to any broker who requests it. Subscriptions are free.

Headlines are sent to your e-mail inbox every other month. Just click the link to read the full story. To subscribe, go to www.deltadentalnj.com, click "Brokers" and enter your e-mail address in the "Consultant News" subscription box.

You may unsubscribe to Consultant News at any time.

If you ever have comments about Consultant News, or have a question or story that you want to see covered, please contact our editor at dbelle@deltadentalnj.com. 

Delta Dental does not sell, rent, or disclose e-mail addresses to third parties. Therefore, you will not receive unsolicited e-mail ("spam") as a result of subscribing to Consultant News.

Delta Dental Receives 'AA-' Rating From Standard & Poor's for Fifth Consecutive Year 

Standard & Poor's (S&P) recently affirmed Delta Dental Plan of New Jersey's 'AA-' counterparty credit and financial strength ratings for the fifth consecutive year. The company's capital position, earnings and business position were cited as the major rating factors. 

Delta Dental's continued high ratings are especially meaningful in the context of a challenging economy. The company has maintained a superior level of capital adequacy, which provides both flexibility and growth opportunities. Earnings, which increased 50 percent from the previous year, came from a balance of underwriting gains and investment income. 

"The brokers and consultants we work with feel confident when offering Delta Dental to their clients because of our financial strength and stability," said president and CEO Walter VanBrunt. "We have been operating in New Jersey for 35 years, and some of our sister Delta Dental Plans have been around for 50 years. We are proud of the fact that Delta Dental Plan of New Jersey remains one of the most highly rated dental plans in the country." 

In addition to the economic assessment, Delta Dental was also evaluated on its business position. It received a ranking of "good" based on a variety of factors including size, market share and competition. The company is the largest provider of group dental benefits in New Jersey and has the largest network in the state. Furthermore, through its access to the Delta Dental Plans Association's national network, Delta Dental also offers access to the largest dental network in the country. 

"As a single-line carrier, our expertise remains focused on offering the best quality dental benefits to our clients," said VanBrunt. 

Studies show that dental coverage continues to be a popular benefit among employees, ranking second only to medical benefits. A properly designed benefits plan has the potential to positively impact the retention of valued staff. Delta Dental is able to offer a variety of programs that make it easy, affordable and convenient for employers to provide comprehensive dental benefits through a strong commitment to innovation and cost-sharing arrangements, and business partnerships with sister Delta Dental Plans. 

"Delta Dental's mission is to promote oral health to the greatest number of people by providing accessible dental benefit programs of the highest quality, service and value," said VanBrunt. "Continued strong S&P ratings affirm that we are a sound company to do business with."

Cost Containment Report Released

Delta Dental saved groups more than $164 million in 2003, thanks to our cost containment measures. These efforts enable groups to manage their expenses wisely while providing Delta Dental's excellent dental benefits programs to their employees.

Savings were achieved in the following areas:

• In-Network Savings - Reduction of billed charges to reflect the participating dentist's filed fee with Delta Dental, the maximum fee level approved for a DeltaPremier dentist, or the maximum charge approved under a PPO program. This represents savings from the utilization of network dentists.
• Contractual Limitations - Procedures denied due to generally accepted dental practice or specific contract limitations such as performance of a procedure in excess of a frequency limitation. It also includes reduction to payments due to Table of Allowance, reduction to the levels upon which payments of non-par dentists are based, and PPO tables (when non-PPO dentists are utilized).
• Eligibility Verification - Benefit denials for procedures rendered during a period of patient ineligibility under the plan.
• Non-Covered Services - Benefit denials for procedures excluded from coverage under the group program.
• Dentist Consultant Review - Procedures which are not supported by diagnostic records or within generally accepted standards of dental care based on direct review or payment policy established by Delta Dental's dental consultants. This includes procedures for which Delta Dental will provide a benefit allowance for an alternative procedure that is within the generally accepted standard of care given the diagnosis or treatment plan.
• Optional Services - Benefit denials or alternate benefit allowances for dental procedures that are considered optional and may be performed at the expense of the patient.
• Non-Billable Services - Procedures that are not chargeable to Delta Dental or billable to the patient. Such charges may include component costs of a more comprehensive procedure, which do not warrant a separate charge, and services denied as duplicate submissions.
• COB Savings - Claim dollars saved through the application of coordination of benefit policies in accordance with the group contract, including non-duplication COB reductions (where applicable) and an enforcement of order of benefit determination rules.

To view our complete "2003 Cost Containment Report," visit our Web site at www.deltadentalnj.com; click on "Brokers" and then "Cost Containment."

Golf Outing Raises $62,000 for Special Olympics

The Fourteenth Annual Delta Dental Classic, which took place in June at Fiddler's Elbow Country Club, raised $62,000 for Special Olympics New Jersey (SONJ). The Delta Dental Classic, which began in 1991, has raised more than $472,000 for SONJ.

SONJ is dedicated to empowering individuals with mental disabilities to become physically fit, productive and respected members of society through sports training and competition.

Contest winners include:
1st Place Low Gross (Women): Cathy Easton
1st Place Low Gross (Men): Jim Schulz 
1st Place Gross Team: Dr. A. Pellegrini, Jim Schulz, Dr. Tom Morgenstern, Dr. Joel Leizer 

Special thanks to all of our participants and sponsors. Delta Dental continues to look to new sponsors to support this outing. Additional sponsorships enable Delta Dental to donate more of the proceeds from the outing to SONJ. If interested in a sponsorship opportunity, please contact Jennifer Appaluccio at (973) 285-4059, or e-mail her at jappaluccio@deltadentalnj.com. 

Sidebar: Mark that Date!
The Fifteenth Annual Delta Dental Golf Classic will take place on June 22, 2005, at Fiddler's Elbow Country Club in Bedminster, New Jersey. The golf classic benefits Special Olympics New Jersey. More details will follow shortly.

What Do You Get When You Call Customer Service? A Friendly Voice, Empathy and Answers

For dental offices and subscribers, our Customer Service agents are the voice of Delta Dental. "We're often the first contact people have with Delta Dental," says Lori Acker, assistant vice president, Customer Service. "We want it to be a great experience."

Thousands of calls come into Delta Dental's call center each weekday. Despite the volume, agents work hard to treat each call as if it were the day's first and only one. "We believe it's more important to make sure people get the attention and information they need than to rush them off the phone," says Acker.

Most Customer Service agents join Delta Dental with previous call center and insurance experience. During their five-week training, they learn about dental benefits, and Delta Dental's philosophy of customer service.

"Our role is to be here to answer customer questions," says Acker. "We've got to make sure our agents have the right tools and the right training so callers don't wait to get their questions answered."

New agent training includes "double-jacking," where trainer-trainee pairs answer customer calls together. Trainees test their skills in real-life situations, while having experienced agents ready to jump in if necessary. Once Customer Service agents begin handling calls, a veteran agent shadows them to help them navigate around stumbling blocks.

Training is ongoing. After six months, every new agent receives another 24 hours of side-by-side training. Agents also receive training in claims processing and adjustments. All Customer Service agents receive an additional 10 hours of training each quarter.

The department recently restructured to make it easier to provide professional development. Several team leaders now provide ongoing agent coaching, to help agents achieve higher levels on Key Performance Indicators (KPIs). KPIs are skills on which agents are routinely measured and impact customer service performance. They include customer service skills, schedule adherence (the amount of time an agent is available to take calls), and claims accuracy, among others. Agents who receive one-on-one coaching have boosted their KPI scores significantly, says Acker.

Delta Dental's retention rate for Customer Service agents is higher than the industry average. The agents combine their training knowledge with experience to help customers. In Delta Dental's annual surveys of benefits administrators and subscribers, Customer Service receives consistently high satisfaction scores. Acker says agents constantly strive to improve their scores. One important measurement is the average speed of answer (ASA). The department has exceeded its ASA goal in 2004. Another measure is the abandon rate-the percentage of callers that hang up before an agent can answer. Customer Service has also exceeded its abandon-rate goals in 2004.

Acker often receives letters from subscribers who describe how Customer Service agents helped them. Agents take responsibility for finding a solution for callers. It's not unusual for agents to resolve enrollment problems, call a dentist's office, or make a special check request to help resolve an issue.  "We go the extra mile for customers," says Acker. "Our agents care about what they do." 

Sidebar: How Delta Dental Provides 24/7 Service
Delta Dental's Customer Service agents answer calls Monday through Thursday from 8 a.m. to 6:30 p.m. EST, and 8 a.m. to 5 p.m. on Friday. In addition, our Voice Response System (VRS) and online Benefits Connection provide self-service answers to most questions 24 hours a day, seven days a week. The VRS, which is accessed by calling Customer Service, provides automated answers to many subscriber and dentist questions, including claims payment information such as deductible, payment made by subscriber, Delta Dental payment, check number, coordination of benefits and whether the maximum has been reached. The online Benefits Connection, which is accessed through our Web site at www.deltadentalnj.com, has everything that the VRS includes, as well as additional detailed information regarding claims payment, all in an easy-to-read and print-friendly format.

Lessons in Home Improvement - Will Evidenced-Based Dentistry Improve the Management of Dental Benefit Plans?
By Dr. D. Scott Navarro, Vice President, Professional Services and Dental Director, Delta Dental Plan of New Jersey

In my halcyon days of involvement in home improvement activities I, more often than I like to admit, fell victim to what I affectionately term "the home improvement fallacy." At the core of this bad thinking was a closely held belief that every new tool was capable of solving an endless multitude of home improvement problems, regardless of the design or purpose of the tool. "I can fix anything if I only had a bigger hammer" was a key mantra evoked time after time in my disastrous allegiance to the fallacy. The root cause of such errors in judgment stemmed from (1) non-critical acceptance of unsubstantiated claims by overzealous salespersons, (2) the inappropriate framing of problems in a context in which it appeared the tool would be successful, and (3) an optimistic desire to improve the quality of life of myself and my loved ones. As one assesses the potential impact of evidenced-based dentistry (EBD) on the management of dental benefits, it is well to remember these lessons in home improvement.

The American Dental Association (ADA) defines EBD as, "an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences."

In order to determine the potential use and effect of this tool on managing dental benefits, it is helpful to understand the historical context in which EBD now presents itself. Recognizing that benefiting dental care violated the most basic principles of insurance, the founders of dental benefit plans were forced to place limitations on benefits in order to control the financial risk and provide affordable and attractive premiums in the competition for employee benefits. Some of the limitations were financially based, such as maximums, while others had links to dental care, such as frequency and age limits. Although supported by the conventional dental wisdom of the time, many of the limitations did not have strong scientific support. Additionally, the primary basis for determining limitations was a "one size fits all philosophy" to do the most good for the most people. Many plans, for example, offered 100% coverage for diagnostic and preventive care and 50% coverage for removable prosthetics. Furthermore, these were contractual limitations that applied to all members of the plan regardless of individual variance. 

Since that time, changing dental benefits has been difficult and the same basic designs continue to persist. There has been greater reliance on scientific evaluation in the assessment of new technology but often the analysis is directed at the individual technology itself and does not lend itself to a comprehensive evaluation regarding the effect of changing benefits across population groups. This latter type of knowledge is imperative if dental benefit designs are to undergo profound change.

EBD offers a more scientific and thereby potentially more effective basis for dental benefit management. This can greatly enhance the value of dental benefits by directing limited available resources to areas where they can provide the greatest improvement in oral health. The issue of poor management of dental benefits is not just one of monetary costs. The true cost of poor management of dental plans is the increased improvements in the oral health of plan members that could have been achieved had the benefits been more wisely managed. As such, it is incumbent on dental benefit managers to take advantage of such new tools as EBD. At the August 2004 ADA symposium, EBD was seen as a tool to help answer such questions as the effectiveness of non-surgical treatment of incipient caries, root canal treatment versus extraction and implant, and whether impacted unerupted third molars should be removed from patients over the age of 25. The answers to these questions could have profound effects on dental benefit design, dental policy, and day-to-day management of dental claims. 

Additionally EBD may provide reliable risk assessment tools that will enable benefits to be designed to take into account individual response to disease and treatment. By providing sound answers to questions such as these, EBD may also prove useful as a lever to convince the purchasers of care it's time to modify their dental benefit plans. In sum, EBD has the potential to become a powerful tool in the management of dental benefits.

Despite its potential to improve the management of dental benefit plans, the limitations of EBD need to be recognized. Several of these limitations immediately come to mind. There may be a lack of scientific information on the subject or the search may leave out important articles. The evidence may be weak. For example, there may be few or no randomized control trials on the subject, or sampling bias may prevent the results from being applicable to the general population. Variances in study criteria may make the results of the meta-analysis dubious. For example, there may be differences in the criteria for determining implant failure. Errors may be made in the interpretation of the evidence. The results of carefully controlled studies conducted in university clinics may not be reflective of the experience in active dental offices. Finally, there may be failure to correctly translate EBD results into more effective management of dental benefits.

In conclusion, EBD holds tremendous promise as a tool for improving the management of dental plans. However, like all tools, it has inherent limitations and deficiencies. There can also be errors in the application of the tool, especially since it is new and most dental benefit managers have limited experience in its use. In this respect, this stage of EBD development calls to mind similar lessons learned in home improvement regarding the application of new tools. Therefore, we should be cautiously optimistic regarding EBD and proceed with deliberation, diligence, persistence, and most of all, patience. 

Reprinted with permission from AADC Beacon, Fall 2004.

Staff Spotlight: Pat Barton

Every year, from September 15 through December 15, you can find Pat Barton either in front of a map or on the road, traveling to meet with one of Delta Dental's client groups. 

Fall is open enrollment time, when companies give employees the opportunity to make changes to their benefits plans. Part of Pat's job during this time, as a Delta Dental service coordinator, involves planning health fairs and open enrollment workshops. "My job is to help educate people about their Delta Dental benefits program," she says. 

At each session, she answers questions, distributes giveaways such as Delta Dental toothbrushes, and shows people how to make the most of their Delta Dental benefits.

Pat expects to attend more than 30 health fairs and enrollment meetings during the fall season. Although her official territory is Bergen and Hudson counties, during open enrollment time, she and the other service coordinators crisscross the state, going wherever they are needed. During the fall open enrollment period last year, Pat logged 4,100 miles, visiting locations in Connecticut as well as in New Jersey.

When open enrollment is over, Pat works with client groups to ensure that their benefit programs run smoothly. When a new group in Bergen or Hudson county joins Delta Dental, Pat prepares employee orientation programs and enrolls employees. 

Pat also helps brokers if they have client issues that need special handling.

Pat joined Delta Dental 23 years ago. She transferred to Marketing as a major accounts coordinator in 1988, and became a service coordinator in 1991. "I work with a lot of wonderful people at Delta Dental," she says. "It's a great place to work."