Originally Shared by Humana | July 20, 2015
Humana’s Dental Refresh is HERE!
Because there are a number of differences that are impacting any quotes run July 1st forward, we wanted to get the updates out to you immediately. These changes apply to all group sizes.
Proposal Changes
- There is no longer a dollar contribution requirement to be employer sponsored. Employer sponsored is now considered a group with 50%+ participation.
- To determine if your quote is based on employer sponsored or voluntary, you will need to review the “Rate details” tab in the quote.
–Employer Sponsored rate detail page – See Dental Refresh Sample quote for an example (below)
–Voluntary rate detail page – See Dental Refresh Sample quote for an example (below)
–A voluntary plan will be 10% higher than employer sponsored.
- All rates are now based on final enrolled count. If the enrolled count changes from one level to another, rates will be impacted. For example, the group is quoted with an enrolled count of 10, but only 7 enroll – the rates will change. It will be very important to quote based on the actual enrollment so that the proposed rates are accurate. See Dental Refresh Case (attached below) size and employer sponsored for an illustration and breakdown of case sizes.
Plan Changes
- Open enrollment standard with all dental refresh products
- Oral surgery automatically included in basic as standard
- Extended Max will automatically be included with all dental refresh products – see Dental Refresh Flyers for more details (below)
- Enhanced Preventive – all plans will include periodontal cleanings, which falls under the periodontal benefit – see Dental Refresh Flyers for more details (below)
- Implant benefit (e.g. crowns, bridges, etc.) is provided for Implant prosthodontics (this is not the same as an Implant rider) – see Dental Refresh Flyers for more details (below)
- To avoid confusion with other carriers’ terminology, we will no longer use the term MAF to represent the highest fee schedule – it will now be referred to as U&C. Nothing has changed with the way the fee schedule is developed. It is simply a name change. INFS is also still available.
New Options/Riders
- Humana will now offer an Unlimited Max option
- Waiving preventive services from annual maximum will be an available option
- Splitting perio/endo between basic and major will be an available option
Other dental news
Effective 8/1/15 all new and renewing Dental Clients will receive electronic ID cards in lieu of cards being mailed to their homes. Members can access the digital card via MyHumana.com or the MyHumana mobile app.
- View, email or print the card from MyHumana web
- View and fax card from app
Don’t forget the significant rate reductions Humana has taken on dental pricing. We have seen some extremely competitive proposals since the price adjustments were made!
Questions? Email Tanya@agent-link.net
