Agenda - 08-30-2011 - 3 - Laserfiche WebLink

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19 DENTAL INSURANC-E The County provides aself-insured dental plan through Delta Dental of North Carolina. The County pays all costs for employee coverage-(claims and an administrative fee to Delta Dental). Dental claims are paid according to a unique Orange County Table of Allowances (TOA), however most claims are paid at Delta Dental's standard reimbursemen# rates. Beginning in 2009, the County initiated a plan to gradually increase its reimbursement levels for claims each year. 2012 will be the final year of this plan. With implementation of the recommended changes in 2012, a.ll Orange -County dental claims will be paid according to Delta Dental's standard reimbursement rates, and the County will no longer have a unique TOA. Employee Dental Insurance is-budgeted- as part of departmental personnel costs. $231,_165 has been budgeted for FY- -2011-12. This amount includes a monthly administrative fee of $2.80/month per employee and a projected premium to cover -claims. Employees pay the full cost of any dependent covera~c e. Since January 2009, the__County has been. systematically increasing claim reimbursements to emplo_y_ees rather than making- a dramatic shift in reimbursements at one time. Staff reviewed FY 2010-11 dental claims with the Delta Dental Account Manager and determined- that the reimbursements for Major Res#orative Services can be increased to the maximum amount- paid by Delta flentaa. The chart below outlines the changes made each past year, and proposed- for 2012_ Reimbursements for Services Increased to Year Delta Dental's Maximum Payable Amount MPA 2009 Dia nostic and Preventive Services 2010 Basic Res#orative Services e. ., fill.in s 2011 Endodontics (root canals), Periodontics (gum treatment) Maj-or restorative services (crowns) increased by 15% instead- of MPA 2012 Major restorative services crowns Additionally, -Delta Dental is applying recent research and best practices guidelines to begin reimbursement for increased cleanings based on specific conditions, certain implants, and posterior composite fillings. These are the first changes Delta Dental has added to its coverage for all its members in over five years. These changes will reduce employees' out of pocket dental expenses. Employees can also manage their dental costs by using providers within the Oelta Dental Premier network and they can achieve greater savings with the PPO Plus Premier networks. At ,the end of FY 2010-11, the dental plan's fund balance was approximately $246,000. By making the recommended change to reimbursements, the County can expect an increase of $40,000-$45,000 in claims over a 12 month period. The administrative fee of $2.55 will increase to $2.80 per member per month (an increase of $2,400/year) effective January 1, A-17