Ben Cohen, CEBS Practice Leader Health and Welfare Benefits Kushner & Company. (269) ben.cohen@kushnerco.com

Transcription

1 The Other Health Benefits - Dental and Vision Trends in Employee Benefits Ben Cohen, CEBS Practice Leader Health and Welfare Benefits Kushner & Company Employee Benefit Consultants t and Administrators i t (269) ben.cohen@kushnerco.com Kushner & Company 2009

2 Ancillary Benefits e Lots of types of ancillary benefits Dental Insurance Vision Plans Life Insurance Short and Long-Term Disability Pre-Paid Legal Cancer and other specific coverages Pet Insurance Long Term Care Lt Lots of others

3 History Health benefits became commonplace during WWII with wage freezes Ancillary benefits, such as dental and vision came much later Additional tools to recruit and retain employees More benefits being added each year Boom times allow more creative benefits Tough times tighten those available

4 Today s Focus While most of the focus is rightly on healthcare these days, ancillary benefits such as dental and vision coverage are still an integral part of any complete benefits program. What are employers around the country are doing now with dental and vision? What they are reviewing ing for the future with regard to dental and vision?

5 Common o Dental Coverages Dental Insurance Half insurance, half reimbursement Administration. Insurance company or TPA Funding. Insured vs. Self-Funded Voluntary vs. Employer Provided Dental PPO vs. DMO vs. Indemnity Indemnity. Go anywhere. PPO. Go where we want you to, and it is cheaper. Go elsewhere, and it will cost you more. DMO. Go only where we want you to go.

6 Common o Dental Coverages Typically three or four tiers of dental coverage Type I Preventive. Cleanings, x-rays, etc. Typically covered at 100% Type II Routine. Extractions, fillings, etc. Typically covered at 50-80%, often with a deductible Type III Restorative. Surgery, major restorations, etc. Typically y covered at 50%, often with a deductible Type IV Orthodontia. Often a voluntary add-on benefit Typically covered at 50% Annual maximums of $1,000 to $2,000 are common Separate lifetime maximums of $1,000 to $2,000 are common for orthodontia

7 Future Dental Trends Closer links to health plans? Dental health as indicator for health problems, like diabetes More focus on prevention Enticements for regular checkups Move towards more voluntary or more employee contributions tib ti Except for regular checkups May lead to adverse selection Dental discount programs instead of traditional coverage

8 Common o Vision Coverages Vision Coverage All reimbursement, no insurance Discount is most important t part Administration. Insurance company or TPA Funding. Insured vs. Self-Funded Voluntary vs. Employer Provided With health insurance or stand-alone

9 Common o Vision Coverages Common vision coverage designs Annual exams, often with a copay Frames and lenses every months with reimbursement up to a set level Contact t lenses in lieu of glasses reimbursed up to a set level L ik i t i ll t d b t Lasik is typically not covered, but discounts are often available

10 Future Vision Trends Closer links to health plans? Annual visits at minimum Eye health as indicator for health problems, like diabetes Unchecked eye conditions become the health plan s problem at a certain level already Move towards more voluntary or more employee contributions On frames and lenses, not exams May lead to more adverse selection Discount programs without reimbursement

11 Other Options Health Reimbursement Accounts (HRA) HRA(s) that are designed to only reimburse dental and/or vision expenses Health Flexible Spending Accounts Employer contribution that allows employees to use as they need Encouragement for employee participation i i

12 Other Benefits e Short term disability Long term disability Group term life insurance Long g term care insurance

13 Pa Plan Design esg Considerations sdeato s How do they fit into your overall HR and benefits strategy? Are the ancillary benefits helping to achieve those strategies? Are they valued by employees? Are you getting the best bang-for-your- buck for the benefits offered? Who pays how much? Right balance?

14 Questions? s?