Supporting worker satisfaction drives new plan features
By Maura C. Ciccarelli
We all know that oral and vision health are important not just for our quality of life, but also for overall health. With an increasingly competitive marketplace for talent, many employers are seeking out dental and vision insurance programs that respond to employees’ health concerns and ways to manage the overall cost of care.
To get a sense of where the dental and vision insurance markets stand today, experts from three organizations weighed in on these topics, as well as the range of new program offerings, expansion of telehealth programs, and what’s down the pike in the future.
Competitive advantages
“Having a dental and vision offering as part of the employee benefits package is always going to be a positive for an employer when it comes to talent attraction and retention,” says Kevin Cranston, head of product for Reliance Matrix. “But, looking at a recent LIMRA Workplace Benefits Dental Trends Report [January 2023], for U.S.-based private employers with 10 or more employees, only 55% of employers offer dental benefits. That’s a low number in my opinion, which means an employer can stand out if they are offering these benefits.”
Additionally, employers can encourage and celebrate the overall well-being of their workforce, he says. “Untreated dental and vision issues can lead to serious health conditions, so dental and vision preventive visits can be just as critical as an annual check-up with your doctor.”
Other studies agree with Cranston’s assessment. Dental and vision insurance are in the top five most important benefits that employees consider when making job decisions, according to the 2023 Workplace Wellness Survey by the Employee Benefit Research Institute (EBRI).
Plus, last October, the 2023 State of America’s Oral Health and Wellness Report commissioned by Delta Dental Plans Association reported that 87% of respondents agreed that dental insurance gives them peace of mind and 85% recognized that dental insurance helps save money in the long run. Nearly nine out of 10 (86%) said having dental coverage allows for good overall health.
Dental offerings
What’s new with dental programs?
“We know that there are links between oral health and systemic health, such as cardiovascular disease, diabetes, and complications such as pre-term low birthweight babies,” says Joi Tillman, chief commercial dental officer for Sun Life U.S. “We’ve seen some plans that allow expanded dental benefits for members that have some of these medical conditions.”
This medical-dental integration (MDI), she says, has the potential to decrease overall healthcare expenditures. MDI, which also is called interprofessional practice, is a science-based approach that shows addressing health issues holistically—not just oral care at the dental office and physical care at the medical office—improves outcomes and increases access to care.
Kaleb Bledsoe, national practice leader of ancillary benefits for BenefitMall, notes that employees’ requests for additional benefits are flowing through to dental plan design. For example, employees are asking for coverage of occlusal guards or night guards more frequently, and dental providers are promoting the coverage.
“Employees are also requesting more cleanings,” he says. “Most dental plans standardly come with two annual cleanings, but we are seeing increased requests for three cleanings. Preventative care and maintenance are important for preventing more serious oral illnesses from developing.”
Vision benefits
On the vision side, carriers are promoting coverage of nonprescription sunglasses and blue light blocking glasses in response to employee requests.
“There was a significant increase in the purchase of blue light blocking glasses during the pandemic as employees were spending more time in front of screens because of more virtual meetings. The need continues as remote work remains popular,” Bledsoe says.
Virtual eye exams continue to grow more popular as the online prescriptions become more accurate.
“This allows employees to quickly get an updated prescription and get it shipped straight to their homes,” Bledsoe adds. “In-person office visits remain necessary for diagnosing cataracts and illnesses such as glaucoma. A challenge for virtual care is that it may allow employees to let these issues go unaddressed for too long.”
Tillman says higher frame allowances and benefit for a second pair of glasses are becoming more attractive in vision plans. Plus, use of online eyewear shops have increased in popularity, making getting new glasses and contacts easier.
Healthy benefits
“Oral health connects to many different types of diseases such as type 2 diabetes and poor oral hygiene is often connected to increased mental health claims,” says Bledsoe. “Focusing on offering education around maintenance and consistent cleanings can help reduce medical claims and keep the overall experience trend across the employer’s benefits down.”
Also, Bledsoe notes that if an employer’s dental claims are running higher than expected, it’s often an indicator that other parts of their health plans are going to start being impacted. Adding an Employee Assistance Program (EAP) for mental health counseling and assistance can help prevent larger health issues from manifesting.
Vision plan benefits go beyond simply supporting eye health, adds Tiffany Stiller, senior vice president, Carrier Relations for BenefitMall.
“There are numerous health problems that can be identified through an eye exam, including diabetes, high blood pressure, heart disease, and cancer,” she says. “Based on this, carriers are putting more focus on integrating medical, dental, vision, and disability benefits and many provide bundling discounts for writing these plans together. When conditions can be identified early it results in better health outcomes and reduced overall costs.”
Inflationary factors
The cost of dental services has increased over the prior year, notes Tillman. Plus, members are hitting their annual plan maximum more often, especially if they are seeing an out-of-network provider.
“There was a
significant increase in the purchase of blue light blocking glasses during the pandemic … . The need continues as remote work remains popular.”
—Kaleb Bledsoe
National Practice Leader,
Ancillary Benefits
BenefitMall
Cranston says that, as with any insurance coverage, employees weigh the impact of dental and vision programs on their personal budgets.
“While it would be great to see more employers cover 100% of the premium and ease the burden for employees and eliminate a benefit decision they need to make, that’s probably not realistic for many employers,” he says. “But it is important to keep the costs reasonable for employees since these coverages are important to overall health. Take dental, in particular—no matter how well someone takes care of their teeth, issues are going to arise and having a dental plan to fall back on is always going to be a better situation than having to find care without having insurance.”
Tillman notes that Sun Life U.S. is seeing requests for richer plans in some geographic areas, including higher maximums and no deductibles, as well as more employee-paid coverages.
The rising cost of dental procedures in all markets is driving up costs, adds Bledsoe: “Pre-pandemic, the most common annual max we would quote on a dental plan in many of our markets was a $1,000 annual maximum. Now we are frequently quoting $1,500 annual maxes as the new ‘standard’ dental plan in many markets as major services have become much more expensive.”
“Employees are busy, with work, with their
families, with life. If there is a virtual/telehealth option for their needs, it can make the process quicker and less stressful.”
—Joi Tillman
Chief Commercial Dental Officer
Sun Life U.S.
Crowns, implants, and other procedures also are driving the need for higher annual maxes from $2,000 up to $5,000 or even unlimited annual maximums.
“Although it is still generally rare for employees to hit these maxes in a calendar year, it is much more frequent for employers to inquire about offering these types of plan designs as a ‘catch all’ for their employees who may need the more costly dental procedures,” he says.
Telehealth and more
One holdover from the pandemic shutdown is an increased interest in telehealth access for dental and vision programs. These can include virtual consults for evaluating and scheduling emergency in-person care as well as establishing an ongoing treatment plan for more complicated conditions.
“Employees are busy, with work, with their families, with life. If there is a virtual/telehealth option for their needs, it can make the process quicker and less stressful,” says Tillman. Sun Life U.S. and its dental business, Dentaquest, have partnered with teledentistry.com to ensure fast access to in-person care.
Plus, employees continue to work remotely and many are living in more rural/non-urbanized areas where access to care is more limited.
“For these employees, access to in-person dental can be challenging as networks are not as developed,” Bledsoe explains. “Teledentistry is a good fit for these employees to diagnose urgent issues and establish a timeline for an employee to get into an office. Telehealth/teledentistry additionally remains helpful for allowing physicians and dentists to virtually prescribe pain management medication as well as to provide temporary relief.”
“Untreated dental and vision issues can lead
to serious health conditions, so dental and vision preventive visits can be just as critical as an annual check-up with your doctor.”
—Kevin Cranston
Head of Product
Reliance Matrix
Carriers are also promoting a new benefit: mobile dental services.
“These services will schedule a dentist and/or hygienist to travel to work locations and set up a dental ‘pop-up’ appointment so employees can access cleanings and exams during a break,” he adds. “These help serve workforces who have a concentration of rural employees who do not have access to traditional dental care.”
The future
Stiller says brokers and agents should watch for another emerging trend: Individual Coverage Health Reimbursement Arrangements, or ICHRAs, which allow companies to give employees a defined amount of money with which to purchase benefits that meet their own needs. This is generally used to purchase individual medical coverage, but employees can also use these funds to purchase dental coverage.
Encouraging employees to take their oral health as seriously as their overall health has led some supplemental health policies to offer a wellness benefit for dental exams, says Cranston.
“While a wellness benefit is not necessarily a large amount of money—typically $25 or $50 paid one time over a 12-month period—it can certainly serve as an incentive for an employee and/or one of their covered family members to keep up with their annual visits to the dentist,” he says.
For more information:
BenefitMall
benefitmall.com
Reliance Matrix
reliancematrix.com
Sun Life U.S.
sunlife.com/us
The author
Maura Ciccarelli is a freelance journalist originally from Philadelphia who now writes about business and more from the road full-time.
Bledsoe says Dental Service Organizations (DSOs) are growing more popular as younger dentists enter the workforce and need to manage higher student loan debt and the cost of dental and medical equipment, both impacted heavily by inflation.
“These factors have made it more challenging for dentists to open their own local practices or buy into the small family practices in their local areas,” he explains.
DSOs have provided access to equipment, administrative staff, and expanded dental networks. Insurance carriers are now negotiating with DSOs as well as local dental offices.
“Private equity continues to invest heavily into DSOs, and we expect these organizations to grow and gain more market share in competition with the local practice model,” Bledsoe adds.
Finally, since AI is on many people’s minds these days, Tillman notes that carriers are trying to figure out if Generative AI has a place within the industry.
“It cannot be used 100% for every determination,” she says, “but, it could expedite care and increase access more broadly.” n
