BPI is Your Pediatric Dental Solution!

Just as your early 12/1 renewals are winding down and you can finally take that giant deep breath, relax and do some light reading on the progress of Healthcare.Gov (I’m being facetious), out of nowhere comes a new test for your experienced benefits mind—pediatric dental in small group!  

I’ve been out doing quite the road show lately regarding this little wrinkle in the law and no doubt this thing came up on all of us out of nowhere. 

I trust by now all you have a working knowledge of the situation but if you’re still at the 101 level, you can access a recent blog post of mine that outlines it here.

If you’ve moved past the point of needing to understand it to the point of trying to figure out a strategy, Benefit Profiles Inc has you covered.  In the articles below, we will give you sound and outlined answers to this pediatric dental test starting with a very BIG announcement!

Benefit Profiles Inc, New GA for Delta Dental!

I am pleased to announce BPI has entered into an agreement with Delta Dental to distribute its products as a General Agent in Michigan.  This is a great fit for many reasons:

•            Benefit Profiles Inc’s pedigree and expertise in distributing small to medium sized group ancillary benefits, especially dental.
•       Delta’s recent development of a small market strategy which includes very competitively rated certified EHB dental plans as well as the benchmark stand alone pediatric dental plan in Michigan.

Those of you who work with Delta in the small group know that right now you can utilize a generic inbox to procure quotes and submit new business.  Now with BPI we can send you small group quotes in a day utilizing an online quoting system.  We can aid you in placing new business and in ongoing service and none of our services will add cost in commissions nor your groups in rates.  Delta sees our involvement as a win-win both in extra administration for them as well as the ability to reach further into the agent community with our footprint. 

The Solution for Pediatric Dental

What further makes the addition of Delta so exciting to us at BPI is, much like you, we need a stand- alone pediatric dental carrier.  It’s become very apparent in the past few weeks that there are three distinct scenarios for dental in the small group following 1/1/14:

•          Group has Blue Cross but no dental and needs to find a solution to comply--View our Solutions Chart!
•          Group has PH but no dental and needs a solution--Solutions Chart
•          Group has a fully-insured medical carrier and a stand-alone non-compliant dental carrier and would like to come into compliance with the EHB--Solutions Chart

Scenarios 1 and 2 are fairly simple with apparent solutions.  But Scenario 3 is causing consternation for all of us involved in distributing small group dental simply because most of the dental carriers are not certified EHB carriers for 1/1/2014.  This includes Companion Life and Kansas City Life! 

So what are the solutions? 

Scenarios 1 and 2—Blue Cross or Priority Health Groups with No Dental Currently

The easiest way to solve this issue is to add Blue or Delta Pediatric Stand Alone dental to the plan.  This costs roughly $25-$33 a kid and it maxed at three kids so $25 to $90 monthly tacked on to a double or family rate.  Yeah, just like that.  Fun huh? 

Given we know the group has to purchase pediatric dental and we know the stand alone options are expensive, BPI would like you to consider finding solutions that might stretch those dollars.  If we gulp down hard and accept the fact that employees in small groups will have this new burden of cost, isn’t it our jobs as agents to see where the best value lies for the money? 

In this vein, we would urge you to look at Met or Delta’s value plans.  Met offers a great MAC (Mandatory Allowable Cost—In Network Only Plan) option that can get family rates below $90 monthly.  The idea here is if the cost is going to be $90 for three kids, why not find a plan that will cover the parents at the same price?  The in-network only is a pain but Met’s network is bigger than Dentemax and remember, these folks have no dental today.  Something is better than nothing!

Delta offers 50/50/50 or 80/50/40 plans that could get to this price point as well. 

Scenario 3—Blue Cross or Priority Health Group with A Non-Compliant Stand Alone Dental Plan

This is a stickier situation than the previous two scenarios: the group has already established a dental plan like Companion Life who has not been certified to sell an EHB plan in Michigan.  What are the options?

The first way to handle this is to simply add a stand-alone pediatric option from either Blues or Delta to satisfy the EHB requirement.  This is expensive but many agents are doing this just to ensure everyone is in compliance.  The question remains then, what to do with the Companion Life.  The first thing you could do is to leave the Companion in place.  The kids would be double-covered, Blues or Delta would be primary and Companion secondary.  And the Companion would offer pediatric ortho and some other benefits the pediatric option would not.  The other option would be to carve the kids right off the Companion plan and do an adult only plan.  The final choice would be to do a ‘wrap’ option with Companion whereby the adults are covered on a full dental plan but the children under age 19 have certain benefits the pediatric only doesn’t cover like orthodontia.  Simple huh?  This option is clunky but it does very much satisfy the EHB requirement so some agents are strongly considering it for some groups especially where the stand alone dental plan is voluntary already.

The second way to handle this scenario is to simply replace the stand alone dental plan with a certified EHB plan.  In this option BPI would send you only Met, MMA or Delta quotes and we could help you understand the differences, pros and cons to moving to this type of plan. 

Want to Talk Further?

Give me a call at 616.481.8675 or shoot me an email and we can cover all of this in person.  I'm very proud of the solutions we have developed at BPI to help agents pass this test and I'm happy to drive to see you! 

Introducing New Staffer, Bobbie Leach

By Dominic Siciliano

Those of you who work with us closely may have interacted with our summer intern, Jason Sissing.  Jason has since gone back to school but one thing we learned having him around was that we definitely need a more permanent position in the role he was filling.

So, after a rather extensive search, we are very happy to report Bobbie Leach has joined our team.  Bobbie is somewhat new to the benefits business, but has extensive experience in service and small business.  She’ll be handling service, claims, and billing issues as well as quoting groups with two through twenty-five eligible lives.

The addition of Bobbie is an important step for Benefit Profiles.  Our commitment is to make working with us the most pleasant thing you experience throughout your benefits day.  A big portion of that will be that we are quick to respond when you need us and Bobbie is essential in upholding that standard.

You can reach Bobbie through our office line 888.313.9571 or through her email at Bobbie@benefitprofilesinc.com.  

Pediatric Dental --Dissecting the Issues and Laying Out the Plans for BPI

By Dominic Siciliano

In the spirit of full disclosure I have to admit that up until a few months ago I was very much in the dark about the pediatric dental benefit under the essential benefits with PPACA.  We knew it was going to be part of the essential benefit requirement and we knew the medical carriers would have to offer some option as part of the Essential Benefits, but we really didn't know how this would look and how our dental carriers would handle it.

If you are playing catch up with this portion of the bill and what it means, this fact sheet and PowerPoint from the National Association of Dental Plans are a great study.

In a nutshell, PPACA dictates that medical carriers in the small group and individual markets starting in 2014 must offer a pediatric dental benefit.  The benefit must follow a benchmark set out from the state or HHS depending on the makeup of the Marketplace in the state.  Michigan’s benefits are based on a Delta Dental Chip program plan, found here.  It is a basic dental plan complete with Type 1, 2 and 3 services.   Notice it does not include medically necessary orthodontia.  We’re one of only two states who will not require it in the EHB (Essential Health Benefits).

The issue facing small groups is how to administer this new benefit.  Will it be through the medical carrier or through a stand-alone dental like the ones we offer here at BPI?  And what is the group's liability if they choose to ignore the mandate altogether?

Some medical carriers will 'embed' the pediatric dental.  Others will offer it as an add-on or as a bundle.  Embedded pediatric dental could be problematic.  It will add expense to the family medical rate and the medical deductibles will apply to Type 2 and Type 3 dental services.

Medical carriers who choose to 'bundle' pediatric dental most likely will offer the option for the group to decline.  The group who declines will have attest that it is fulfilling this portion of the EHB through another facet of the benefit package--most typically through a stand-alone dental carrier.  This attestation will resemble closely the HRA attestations you see from certain carriers.  The group will have to provide the medical carrier 'reasonable assurance' that the pediatric benefit is taken care of.

Interestingly though, if the group attests it has pediatric dental but does not, they are not liable in any way.  Remember this is small group.  There is no employer responsibility to offer coverage.  The liability to provide the benefit falls back on the carrier.  It is the carrier's responsibility to ensure they offer a full benefits package in the eyes of HHS.  Hence, the attestation situation.

Blue Cross Blue Shield of Michigan and Priority Health are two carriers who will not embed but rather bundle.  The Blues will offer Blue Dental as an option while Priority will offer a 'soft handoff' to Delta Dental to its clients.

Those dental carriers who wish to have a certified EHB plan must be certified both by the state and HHS.  Most of the carriers who certify will simply enhance their current family coverage with the pediatric portion.  It will cost a bit extra, but generally much cheaper than the medical offerings.

We’re excited to report MetLife along with the MMA will be an exchange certified dental plan.  All small group policies will automatically be updated with the pediatric benefit 1/1/2014.  The cost of about 2% in overall spend will be added at renewal.  To learn more about how Met will be handling this, click here.

As for our other carriers, Companion Life produced these two very good pieces (ACA Dispatch Letters and ACA Q&A) regarding the dental benefit.  They have chosen to take a wait and see approach for the first few months, but they do plan on filing a plan for next year and hope to have on ready by the second quarter.  Kansas City Life similarly has plans to file but will not be certified 1/1/2014.

It’s safe to say it will be best to unbundle this benefit from the medical.  The benefits will be cheaper and easier to access for the employees and groups.  Of our portfolio, MetLife and MMA are certified EHB dental plans.  Stay tuned to our email blasts and blog as we continue to update you on new guidance as it comes forth.

Introducing Kansas City Life Group Benefits

By Dominic Siciliano

Last summer about this time I came to Lena telling her we were adding a new carrier.  “Shouldn’t be too much extra work,” I told her.  I have to admit I was kind of wrong when I told her that.  Really though, how could I have known how hot their rates were going to be and how easy they were going to be to work with?

Indeed, if you’re new to Benefit Profiles Inc or if you’ve been quoting with us this entire year, I think you’ll agree once you get to know Kansas City Life as we have, that they are worth being busy with.  Why?  Below are some compelling reasons:

1. Competitive dental rates and flexible plan designs—KCL can accommodate just about every plan design wrinkle you’d need.  In addition, KCL offers rolling annual maximums (think Always Care and Guardian) as well as the ability to give credit for $100 lifetime deductibles.

2. Excellent service—KCL is a boutique, plain and simple.  Your groups are assigned to one representative who handles its inquiries from service to billing.  In addition, BPI has great resources to solve problems quickly.

3. An attainable producer bonus program—see the attached brochure here!

4. Flexible LTD contract design—Add or remove prudent person language, soft tissue considerations; maximum income replacements to $15K; add or remove maximum capacity; and/or definition of disability.

5. Compelling Voluntary Life, STD and LTD through the Abacus series. Learn more here!—Will write 1099 employees!

If you’d like to learn more click here or please email me at Dominic@benefitprofilesinc.com.

MMA Offers Voluntary Dental - Now Selling 23 month Rate Guarantees!

By Dominic Siciliano

Most of you are familiar with the benefits of the MMA.  We’ve been excited to represent this unique pooled product for about a year now.  We’re even more excited now to offer voluntary dental.  Not as familiar with the benefits of the MMA?  See below for a brief overview:

• Michigan Manufacturer’s Association is one of the oldest and most respected professional associations in Michigan.  Any group that is not publicly funded can join.

• The MMA features pooled products and have boasted static level increases for years.  This is a very predictable product to budget for.  And, if your group joins now, it enjoys zero rate increase until renewal in 2015.

• The MMA features all the benefits of Met’s rich dental contract.  Remember, no waiting periods for virgin voluntary dental!

For more information on these new programs from the MMA click here or give us a call today!

4th of July Office Schedule

We will be closed July 4 and 5.  Our carriers will be closed July 4 but open July 5.  Should you have a service request July 5, you can find the following numbers below as a resource for each carrier:

Companion Life:          1-800-753-0404
Kansas City Life:         1-800-616-3670
Met Life:                     1-800-638-5000
MMA:                          1-800-842-6513

A Message Regarding Companion Life and the MI Medicaid Tax Assessment

To all Companion Life Agents and Brokers in Michigan:

As you are aware, effective January 1, 2012, the Legislature of the State of Michigan passed a 1% health claims tax imposed on all health insurance claims incurred by Michigan residents.  This includes all vision and dental insurance claims.  Insurance carriers were permitted to collect this tax directly from their insured employer groups.  Companion Life Insurance Company has been paying this tax each quarter since its inception while we retooled our billing system to reflect this tax separately.  

Effective July, 2013, Companion Life has added the tax surcharge to all employer group billing notices in Michigan.  The bill will include a tax surcharge of 0.72% of dental premium and 0.74% of vision premium to estimate the 1% tax due to Michigan on claims.  Companion will then remit the tax to the state as required by Michigan law.  There will be no retroactive charge to your clients for January 2012 through June 2013 taxes paid.

A letter of explanation has been included in each group bill.  In addition, future proposals will reflect a footnote that explains that the State of Michigan surcharge is not included in coverage rates within the proposal.

If you have any questions or comments, please contact your Companion Life representative.

 

Trescott N. Hinton, Jr.

President, Companion Life Insurance Company

Timely Topics - Summer 2013

By Dominic Siciliano

The Companion Trip—Vienna, Austria!

After a crazy year, treat yourself to some European relaxation. Companion really takes care of you on these trips.  Let’s talk about getting you there!

Companion’s Voluntary Life Age Freeze and Vol. STD/Life Bonus Incentive

Companion’s STD and Life are both unique for a variety of purposes.  The entry age freeze and complimentary AD&D on the STD is great.  In addition, it will replace worksite carriers’ STD as a takeover with pre-ex waived.

MetLife’s Benefits Intelligence

This is their annual benefit study in a nutshell.  I find it very powerful how employees versus employers comment regarding voluntary benefits.  This piece could be a compelling add to your proposals as you revise the way your groups look at employee benefits.

MetLife’s Complimentary Will Preparation

When I think MetLife, I think great value and this will prep program is not utilized enough by agents and groups.  Free face-to-face will preparation with a real, live attorney when employees purchase supplemental life!

Allstate’s small group Critical Illness

Guaranteed Issue down to five lives, in most instances; Aflac takeover with no pre-ex; one flat rate for all of Michigan.  This is a home run!

You Have a Friend in Us

By Dominic Siciliano

It’s been over a year since Agent Alliance closed and Benefit Profiles began.    We want to sincerely thank you for your business.  We would not be here if it weren’t for your support.

But boy, what a difference a year makes!  As I travel into your various agencies, I’m amazed by the amount of work that faces each one of you to ensure your clients appropriately navigate this next year of renewals.

We just want you to know that we are here for you.   We continue to work to gear up our service to make dealing with us smooth.  You may have noticed you are receiving emails from a new employee.  Jason Sissing has joined us to help with small quotes and employee adds and deletes.  In addition to Jason, we are actively seeking another person to help service your block.

Never hesitate to call us with anything we can do to take some pressure off your plate.  We look forward to being the Tonto to your Lone Ranger this fall and we’re excited to work through it together!

Thanks for a Great First Year!

By Dominic Siciliano

Those of you in Michigan may not believe this by the weather but it is June.  June is a special month for Lena and I here at Benefit Profiles Inc because it marks the one year anniversary of our new beginning.  June 1st is our official start date.

I wanted to take a second to say thank you to all of you agents, account managers, and agency staff who have been so supportive to Lena and I.  You have been patient with us as we recreated and revised who and what we were this past year.  We don't exist without our agent relationships and we live to hear your voices and interact with you on a daily basis, so thank you.

After a year, we've seen great growth.  You may have noticed our website is much more updated.  That is because we hired a marketing intern, Jason Sissing.  Jason is a student at GVSU and he is very talented.  I'm just hoping that when I'm old and gray he sees it in his heart to remember the 'little people' who helped him get to the top because that's where he's surely heading.

We continue to add carriers and services.  Allstate has been a great addition as they have introduced us to so many interesting and innovative firms who can bring brand new services and solutions to your clients.  Look for a call from me in the near future to discuss these opportunities.

But beyond the business and beyond saying thank you to you, our agents, I find it important to take moments to simply appreciate what we have.  After all we've been through in our industry and especially as former MA's, don't we still have to look around and say, 'Man, we have it pretty good." We see so many different groups in our various employee meetings and we see how so many people earn a living.  For my money, I wouldn't want to do anything else.  Yes, we're in a crossroads in our industry but that just means we have an opportunity to reinvent ourselves.  Look at us here at BPI, I think we can be somewhat of a poster child for that theme.

So on that note, I wanted to share two videos with you today to make you smile.  The first is the recent Pure Michigan ad that will be running nationwide to a variety of states.  It features my hometown, Grand Rapids, MI and it makes me proud.

The second is a Youtube video my daughter's second grade class put together.  Find it here!
This makes me smile.  My little Natalie was two days old when I walked into Priority Health on my first day in the insurance industry.  Now, she's eight and bouncing around happily with her classmates.  Needless to say, we're both doing just fine.  Couldn't have been possible without you.

Cheers!

Dominic

The Best Voluntary Short Term Disability in the Market

By Dominic Siciliano

Former NAHU President, Mel Schlessinger, once proclaimed Companion Life’s Voluntary STD product the best in the market.  I happen to agree with him and here are the reasons why:

1.  Entry Age Freeze--once a member purchases this product he/she will always be considered by Companion to be that age.  This means simplicity for HR people and no hassle of updating age chart every year.

2.  Employer chooses the plan design but the employee chooses the weekly benefits.  The employee chooses what he/she can spend monthly from the paycheck and can always buy up.

3.  Guaranteed Issue at initial open enrollment and a waiver of pre-ex in a takeover situations.  This product should replace Aflac STD in every one of your groups.

4.  Minimum of 5 enrolled required for a group above 10 eligible and minimum 3 needed for a group below 10 eligible.

5.  Maternity and Mental Health treated as standard disability.

6.  Flat 15% commissions plus a bonus in 2013 for selling voluntary life along side.

Details of this program can be found here or if you'd like to have a discussion in your office, call 888.313.9571 to set up an appointment.

Consider This. . .

In a 10 person group, let’s say four people enroll in the benefit.  Employee 1 purchases a $350 weekly benefit for $32 monthly while Employee 2 purchases $700 for $64 monthly.  The other two total another $90 for roughly $182 monthly.  You make an extra $27 monthly on the case so your four person group just became a five person group. 

Multiply this by 10 and you have a 100 person group.  40 people take the benefit for a $2000 monthly bill.  You make $300 monthly and $3600 annually on the benefit.  That’s just like adding a small group to your book of business.

Lifetime Deductible Takeovers and Credit for Dental Max Rollovers

By Dominic Siciliano

It is common for agencies in the Michigan market to feature both lifetime deductibles and increasing dental maximums.  Companion Life and AlwaysCare were big drivers of the lifetime deductibles while Guardian and AlwaysCare featured the dental max rollover accounts.  

But as you know, dental premiums do increase and it is always possible to find a cheaper carrier.  It is tougher though to find a carrier who will give credit for lifetime deductibles and rollover maximums.  Kansas City Life Group Benefits will do just that.  

I know what you’re thinking—Kansas City Who? Kansas City Life is our newest dental partner.  They are A rated, very service oriented and relationship driven.  They have a solid dental network and they pay at the 90th percentile out of network.  They are very flexible with their plan designs and they are interested in takeover business.  

For more information on KCL, click here. 

If you quote with BPI, we will furnish you with quotes for Companion, MetLife, MMA and Kansas City Life.  If you have a Companion case you are taking to the market, we’d love to see what our other carriers can do to retain that business with BPI.  In addition, we can always ask Companion for experience and to review the increase for possible relief.

The Best Kept Secret—Free Will Preparation with MetLife’s Supplemental Life Insurance

By Dominic Siciliano

BPI is proud to represent MetLife for a variety of reasons.  Their dental contract is rich with a huge network and brand recognition, their financials are strong and their local service is top notch.  In addition, because Met is so big and services so many mega groups, their products tend to reflect very unique value-adds. 

This is notable in their supplemental life insurance program where Met offers free will preparation service for any member who purchases a minimum voluntary life benefit of $10,000 or more.  This will preparation takes place with an actual live attorney from the Hyatt Legal Network, a network that Met owns.  The benefit allows the member to meet face-to-face with the attorney at absolutely no extra cost.  Details of this program can be found here.

I have been through several enrollments now with Met Voluntary where this benefit alone drove more supplemental life sales and really became a great value to the employees.  Remember, voluntary life pays flat 15% commissions and you are doing your groups’ employees a great service in the process.  Studies have now shown that the majority of Americans do not carry life insurance and the majority of the ones who do buy it through work more than on their own individually.

Worksite Benefits from a Core Guy’s Perspective

By Dominic Siciliano

I grew up a Core guy.  I cut my teeth at Priority Health learning Medicare Advantage, then moved over to Agent Alliance to work with agents' Blue Cross in small groups.  Just as recently as a year ago, I had one thing in mind—how do we quote to get new medical groups or keep the ones we had. 

Sure we sold Companion Life and we talked Voluntary Dental—a sale that seemed natural and easy enough.  Medical benefits are expensive enough, it made sense to me groups would offer the opportunity to purchase dental as a voluntary add on.  And voluntary life—that made sense.  Even STD and LTD seemed like a nice, easy way to offer employees financial protection on a voluntary basis.  

But what about that other stuff—critical illness or accident?  I have to admit, I was skeptical.  I saw how expensive the medical benefits were—I see how agents continued to move and change benefits just to keep plans in place.  How could we ethically recommend even more spend of the employee’s dollar? 

So I started asking agents about it.  Do you sell voluntary, more specifically worksite?  If so, how do you do it?  What carriers do you sell?  The answers were varied from agents who told me they despise the very idea of it to those who told me they are experiencing great success and their groups are really enjoying the benefits.  But the process still seemed odd to me.  How does it work?  How do they sell it?

I began talking to the carriers.  The answers were hard to come by.  Some told me they had to accompany the agent on every sale because they are the experts.  No, that doesn’t feel right.  Others told me the products ‘sell themselves’ and they just need the opportunity to quote.  That’s not right either.  Then finally I found one who told me their style is to find areas they can enhance the benefits experience, lower core costs or even solve employer issues through their varied resources with several enrollment platforms.  This started to fit.  I finally began to see how it could work—if through the enrollment process (which is necessary for voluntary benefits) the agent can solve essential employee or employer pains, then the sale becomes a solution.

BPI, Allstate Benefits and You—The Professional Solution

By Dominic Siciliano

What about the cost of worksite benefits?  I know how much employees are paying for the core benefits alone.  How do we reconcile selling them even more?  These are questions I struggled with as I ventured into this side of our business.  I discovered the answer in our very first Allstate sale. 

It’s a 70 person group.  The group owner is passionate about her employees and is proud to offer medical, dental, disability and life.  But she had to make a tough decision this renewal and raise her deductible to $4000 a single.  You all have heard this hundreds of times.  The owner just didn’t want to force an increase of the employee contribution but she couldn’t absorb the increase.  But she was worried about that exposure for the employees.  She knew an event would ruin them financially—that very few of them had $4000 of dispensable income.  

So the agent went looking for a solution.  With Allstate he found she could offer her employees a chance to buy protection from much of this exposure on a voluntary basis.  They offered group critical illness and accident.  These are guaranteed issue group products with blended rates.  The agency ran the meetings and enrollment in a day.  The employees, although not thrilled with the increase in medical deductible, were happy to have at least an option of protection and many enrolled.  The group decision maker was pleased that she wasn’t leaving them totally in the lurch.  And the agent increased his commission and his value in one of his best client relationships.

I’m not trying to sugar coat anything though.  No one thinks that this is a great situation for employees.  But the reality is agents get paid to offer solutions.  In this case, Allstate was a great brand with very unique, group-filed worksite products that acted much more like traditional benefits than individual worksite products. 

More and more, these situations will require a partner like Allstate. Benefit Profiles Inc has access to a variety of systems, products and ideas surrounding the voluntary benefits.  Give us a call to discuss a meeting where we can dive more deeply into the details of products and where they would work in some of your groups.

Introducing Benefit Profiles Inc

By Dominic Siciliano

Benefit Profiles Inc is a group benefits General Agency with the mission of partnering with agents to help grow their business.  We have a commitment to personal service and we work with carriers who share this same commitment.  All our carriers are A rated and dedicate themselves to getting the job done right. 

To learn more, click here.