Articles
Do Your Employees Know About Delta Dental's Free Online Newsletter?
Important Reminder Regarding Bill Payments
Dental Benefits Buck Health Care Trend
School Districts Give Delta Dental Top Marks Year After Year
Dental Networks for All Delta Dental Programs Continue to Grow
See How We've Grown in 35 Years
Dr. Navarro Tackles Critical Issues Editing Magazine for Dental Consultants
Questions and Answers about COBRA
Time for Employees to Verify Student Eligibility

Do Your Employees Know About Delta Dental's Free Online Newsletter? Use the Flyer to Get the Word Out!

Subscriber News is a free monthly publication for all Delta Dental subscribers. Each issue is delivered to their e-mail box and features information about how subscribers can make the most of their Delta Dental benefits. Subscriber News covers everything from how to find a participating dentist to where to get detailed explanations about their family's benefits, and much more. 

One way to communicate to employees about this free newsletter is with a flyer. Delta Dental created the layout for one, which is inside this issue and is designed for easy photocopying. All you need to do is photocopy and post on bulletin boards, or distribute through interoffice mail. 

If you would like an electronic copy of this flyer, please e-mail dbelle@deltadentalnj.com. 

Subscriber News headlines are delivered to readers' e-mail inboxes each month. Readers can just click the link to read the full story. You and your employees will be happy to know that Delta Dental does not sell, rent, or disclose e-mail addresses to third parties. Subscribers will not receive unsolicited e-mail, or "spam," as a result of their subscription.

Important Reminder Regarding Bill Payments

Please include the remittance page when sending payment. The remittance page is essential because it tells us which account should be credited with the payment. It is especially critical when several sublocations pay their own bills.

We want to be sure to credit each payment correctly. Please help us by kindly including the remittance page with your payment. This helps ensure that your payments are posted correctly. It will also help save you the inconvenience caused by payments being credited to the wrong account.

Dental Benefits Buck Health Care Trend
Percentage rise in premiums subsides

The average annual increase in the cost of dental premiums has stabilized since 2001, as premium increases for medical benefits remain well above 2001 levels. Dental never saw the double-digit volatility that keeps medical costs in the news. But while medical increases remain at rates high above the original 2001 spike, dental has cut across the trend and climbed down over the same period, according to new industry analysis.

Employers, who cite pricing stability as among dental's most attractive attributes, might find it easier to continue spending on the popular benefit, which has long been ranked by employees as their second favorite next to medical.

"If you can decrease pricing pressure in the benefits package when soaring medical costs are squeezing other benefits, it's bound to be welcome news," said Tom Dolatowski, vice president of marketing for Delta Dental Plans Association.

A recent market report from Mercer, a health care consultancy, indicates that the average dental-benefit cost will increase by about 6.8% in 2004, compared with an increase of 7.6% in 2001. Annual increases in fee-for-service dental plans and preferred provider organizations (PPOs) have been declining since 2001. Most people are covered by these two plan designs. But costs in dental health maintenance organizations (DHMOs), which provide the highest degree of managed care among dental plans, have risen slightly since 2002, according to the report.

A different report, from the National Association of Dental Plans, gives more detail on what benefits sponsors and subscribers can expect. For example, fee-for-service family coverage from a medium-size employer will cost about $5.75 more per month, compared with last year.

"Dental pricing remains stable because the benefit is designed to drive preventive care. When you prevent or minimize disease, you minimize the need for expensive remedial or restorative treatments," Dolatowski said.

School Districts Give Delta Dental Top Marks Year After Year

Delta Dental Plan of New Jersey welcomed West Milford Public Schools in West Milford, New Jersey, as one of our first groups almost 35 years ago. School Superintendent Robert Gilmartin recently told us why the district has stayed with Delta Dental all these years.

"Whenever we looked around, we came to a collective decision that Delta Dental provides the best options and the best program for us," he says. "There has never been a major issue with the contract, service or implementation over the years."

The program meets the needs of the district's employees, as well. "I don't think I've ever heard of anybody going to a dentist who does not participate with the program," says Gilmartin. "Most participating dentists file their claims for them, so it saves patients a lot of effort and energy."
Gilmartin has been with the school district nearly 30 years, and appreciates the Delta Dental benefit on a personal level. "It's been a nice benefit, especially as a parent. Service is an important piece of satisfaction with the program. From my own personal experience, I'd give Delta Dental high marks in customer service." He adds that in the region's dental benefits market, "Delta Dental is at the front of the parade."

Two things keep the Keyport, New Jersey, Board of Education with Delta Dental Plan of New Jersey: "Consistent employee and employer satisfaction," says Sally Gadomski, who administers benefits for the district.

"We have a large provider population in Monmouth County," says Gadomski. "Most dentists in the area participate. There are no claim forms to handle. Delta Dental has toll-free numbers to address patient questions. Predetermination is good - if you have a lot of work done, you know what your out-of-pocket expenses are going to be."

Gadomski's supervisor, JoAnn Podracky, agrees. "You know right up front what you're going to pay. There are no hidden costs for patients." Podracky also appreciates how efficiently Delta Dental handles coordination of benefits. "We have a lot of husband-and-wife teacher teams, who are both covered by Delta Dental Plan of New Jersey. The coordination of benefits is flawless."

The district reviews its dental benefits program every year or so. "Whenever we review our plan, Delta Dental keeps coming up on top," says Podracky. "The fact that employees are happy makes it good for us. There's a lot of satisfaction with the program."

Dental Networks for All Delta Dental Programs Continue to Grow

Across the nation, three out of four licensed dentists participate with Delta Dental, and the number of participating dentists continues to grow. 

Here's a brief snapshot of our dental benefits programs, and how they could benefit your organization and your employees.

DeltaPremier Program 
This program's network added 551 dentist locations in New Jersey and 323 dentist locations in Connecticut since 2002. This is a growth rate of 9% in New Jersey and more than 15% in Connecticut. The DeltaPremier program features our most extensive network. It also offers employers the best in managed care and cost containment services. Three out of four licensed dentists nationwide participate. There are currently 6,473 participating DeltaPremier dentist locations in New Jersey, 2,493 participating dentist locations in Connecticut, and 142,000 nationwide.

Delta's Advantage Program 
This program is a popular option for groups whose members are located only in New Jersey. Delta's Advantage Program offers access to cost-efficient dental care provided on a fee-for-service basis, and a large network of participating dentists. It allows complete freedom of choice in dentist selection. Delta's Advantage Program network has grown 19% since 2002. There are 4,105 participating dentist locations in New Jersey. 

DeltaPreferred Option Program
This is our fastest growing program. It allows employers to increase the value of dental benefits to employees, while decreasing their overall dental plan costs. The DeltaPreferred Option program costs employers about 20% less than the DeltaPremier plan. This is a popular addition to many employers' "cafeteria" (or flexible) benefits plans. The DeltaPreferred Option network grew 25% since 2002 in New Jersey and nearly 23% in Connecticut. Its network has more than doubled in size over the past five years. It has 3,387 participating dentist locations in New Jersey, 1,136 participating dentist locations in Connecticut, and 67,000 participating dentist locations nationwide. 

DeltaPreferred Option Point of Service Program
This program offers subscribers access to both DeltaPremier and DeltaPreferred Option dentists, providing different benefit levels for each network. It gives subscribers greater flexibility in selecting the dentists and benefit levels that meet each family member's needs. 

DeltaCare Program
Our dental HMO program is administered by Flagship Dental Plans, a subsidiary of Delta Dental Plan of New Jersey, Inc. Employees choose a primary care dentist, who coordinates all necessary covered dental care and referrals to network specialists.

A word about our networks
Delta Dental regularly credentials its participating dentists to help ensure that they continue to meet our standards. Our dental network coordinators meet regularly with participating dentists to ensure that they remain satisfied with Delta Dental. Our dental network coordinators also recruit non-participating dentists into our network. 

Our large dental network and ongoing growth are two reasons why many organizations select Delta Dental Plan of New Jersey as their dental benefits provider. Most subscribers can easily find a participating dentist near their home or workplace. 

In our 2003 Customer Satisfaction Survey, conducted by Brownstone Information Resources, subscribers expressed overwhelming satisfaction with the size of Delta Dental's network, the quality of care they receive from participating dentists, and their dental benefits program overall. 

For more information about our dental benefits programs, please visit our Web site at www.deltadentalnj.com and click "Products" on the navigation bar on the left. Information about DeltaCare products is available by clicking "Flagship" on the navigation bar.

See How We've Grown in 35 Years

A lot of milestones happened in 1969. Neil Armstrong walked on the moon, the Beatles performed their last concert, and ARAPANET (the predecessor of the Internet) was created. 

That was also the year that Delta Dental Plan of New Jersey began fulfilling its mission "to promote oral health to the greatest number of people by providing accessible dental benefit programs of the highest quality, service, and value." On July 8, 1969, the New Jersey Dental Service Plan (our original name) filed the articles of incorporation with the New Jersey Secretary of State. 

Here's a snapshot of how far we've come: 

First headquarters (1970)
A room of Dr. Joseph Pollack's dental office in East Orange, New Jersey
Current headquarters (2004)
Nearly 90,000 square feet at 1639 Route 10, Parsippany, New Jersey

Number of groups:
August 1972: 16
December 2003: 2,200

First claim paid: January 1971, to Dr. Stanley M. Schlossman of Morris Plains, New Jersey
Claims processed in 2003: More than 2.8 million

Participating New Jersey dentist locations: 
1970: 2,200
2003: More than 6,000

Number of subscribers:
January 1971: 4,000 subscribers and dependents
December 2003: More than 1.5 million subscribers and dependents

Claims milestones: 
1974: More than $1 million in benefits paid
2003: $388.1 million in benefits paid

Thank you for helping us to come so far. We look forward to continuing our growth and our relationship with you in the years to come!

Dr. Navarro Tackles Critical Issues Editing Magazine for Dental Consultants

Not many people have heard of dental consultants. Dr. Scott Navarro hopes to change that. As editor of Beacon, the magazine for members of the American Association of Dental Consultants (AADC), Dr. Navarro wants to encourage discussion among AADC members, practicing dentists, and others with an interest in dental benefits.

"Dental consultants are dentists who consult with dental carriers in such areas as claims review, program design, policy setting, quality assurance, building dental networks, utilization review and fraud," says Dr. Navarro, who is Delta Dental's vice president, Professional Services and Dental Director.

Some AADC members maintain part-time private dental practices, while others are full-time consultants. Dental consultants enable dental carriers such as Delta Dental to incorporate the knowledge and perspectives of practicing dentists into their operations. 

"The publication provides a forum to discuss issues pertaining to dental benefits," says Dr. Navarro. "It's designed to create a dialog among dental consultants, dentists and other parties with a stake in dental benefits." 

Although not a refereed journal, Beacon does include research articles. It recently published an epidemiological study on childhood caries and periodontal disease conducted by the University of Medicine & Dentistry of New Jersey-New Jersey Dental School. The Delta Dental Plan of New Jersey Foundation supported the study.

Recent authors included a dental school dean, professors and researchers, dental consultants and practicing dentists. The Spring 2004 issue addressed the difficult question, "How will scientific advances in oral health influence dental benefits?" It featured articles on evidence-based dentistry, data warehouses, and the current (and future) state of oral-health research.

Each issue includes an insert called Second Opinion, in which dental consultants present actual cases and discuss different approaches to adjudication. Dr. Harold Seiler, a consultant for Atlanta Dental Consultants, edits Second Opinion. 

Dr. Navarro encourages anyone with an interest in dental benefits to contribute to Beacon. The editorial address is Beacon, 10032 Wind Hill Dr., Greenville, IN 47124. For more information about AADC, visit its Web site at www.aadc.org.

Questions and Answers about COBRA

What is COBRA? 
According to the Department of Labor Web site (http://www.dol.gov/dol/topic/health-plans/cobra.htm), the Consolidated Omnibus Budget Reconciliation Act (COBRA) gives certain workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.

COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.

COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice.

How long is a person covered under COBRA?
Depending on the circumstances of the qualifying event, coverage is 18, 29, or 36 months. Employees should ask their benefits administrator. 

How do people make COBRA payments and to whom do they send the payments?
Payments are made on a monthly basis. Depending on who administers COBRA, payments will be sent to the administrator. The benefits administrator will be able to guide employees as to who collects the premiums.

If a person is on Medicare or becomes eligible for Medicare, is he/she still entitled to COBRA coverage?
If the person qualifies for Medicare prior to becoming effective for COBRA, the person is entitled to COBRA coverage.

If a person with existing COBRA coverage becomes eligible for Medicare during this time, the COBRA coverage ends.

If a subscriber passes away, how long are the person's spouse and his/her children covered? 
If a person passes away while on COBRA, the remaining dependents on the policy are covered for a total of 36 months from the member's original effective date.

If a member was an active employee at the time of death, the remaining dependents are covered for a total of 36 months from the employee's date of death.

When an employee's children reach the maximum age under the plan, how do the children switch to COBRA?
The employee must notify his/her benefits department, which will provide the necessary paperwork to enroll dependents. 

Where should people get the application for COBRA?
All paperwork pertaining to COBRA must come from the employer.

Where do people get the rates for COBRA?
If Delta Dental Plan of New Jersey is administering COBRA, the rates may be obtained from the Delta Dental COBRA Department, at (973) 285-4145. If the group is administering COBRA, rates may be obtained from the employer.

What happens if a person returns to work while on COBRA and receives benefits through the new employer?
Once someone becomes eligible for benefits through a new employer, the person is no longer eligible for COBRA coverage. If Delta Dental is administering COBRA, the notification must be sent in writing to: COBRA Department, Delta Dental Plan of New Jersey, P.O. Box 219, Parsippany, NJ 07054.

Do a person's benefits start over when going on COBRA? 
No. COBRA is a continuation of existing coverage. Maximums, deductibles and tooth history will carry over. 

If a person becomes disabled during the COBRA coverage period of 18 months, is the coverage period extended?
Yes. Disabled individuals are entitled to a total of 29 months of coverage. A member must provide the COBRA administrator with the proper documentation from a doctor.

When a person enrolls in COBRA, will he or she need an identification card to give to the dentist?
No. When a member goes to the dentist, the member should provide his/her Social Security number and COBRA policy number.

Time for Employees to Verify Student Eligibility

Summer's drawing to a close, and college students will be getting ready to head back to campus. If your employees have college-age dependents, please remind them to complete Delta Dental's Student Documentation Verification Form.

Delta Dental requires subscribers with college-student dependents to provide Delta Dental with proof of their student status when they submit their first claim of the school year. The Student Documentation Verification Form enables subscribers and their college-student dependents to quickly confirm student status without having to submit any other paperwork. 

Students may submit either the Student Documentation Verification Form, or some other proof of their student status. These may include a copy of a paid tuition statement, a registrar's certificate of grades showing at least 12 credits, or a current validated student ID card.

A copy of the Student Documentation Verification Form may be downloaded from our Web site at www.deltadentalnj.com. Click on Forms on the navigation bar on the left side of the screen.