Agenda - 09-14-2010 - 3 - Laserfiche WebLink

Browse Search

Attachment 4 • DENTAL INSURANCE OVERVIEW Page Over the past few years we have been systematically increasing claim reimbursements to employees, rather than making a dramatic shift in costs. In 2009, Orange County increased reimbursements for Diagnostic and Preventive Services. In 2010, reimbursements for Basic Restorative Services (e.g., fillings) were increased. The reimbursements for major restorative services (crowns), Endodontics (e.g., root canals), Periodontics (e.g., gum disease), and extractions still lag. are reimbursed at 50%, a rate consistent with other employers. Because of the difference between County reimbursements and actual charges, employees pay an increasingly higher portion of charges for these services. Staff reviewed dental claims and determined that reimbursements for Endodontics, Periodontics, and Oral Surgery can be increased with little impact to the Dental Fund balance. Reimbursements for Major Restorative Services can be increased by 15%. At the end of FY 2009-10, the dental plan's fund balance was in excess of $300,000, and the fund continues to be robust. The administrative fee of $2.25 will increase to $2.55 per member per month (a total increase of $2,200/year) effective January 1, 2011. The fund will be able to absorb this budgeted increase of $.23 per employee per month as well as the anticipated increase in claims. • Su ested Plan Changes: gg • Increase reimbursement for Endodontics, Periodontics, and Oral Surgery to Delta Dental rates • Increase Major Services by 15% By making these two changes, the County can expect an increase of $38,000-$45,000 in claims over a 12 month period.. •