TRICARE Dental Program and TRICARE Retiree Dental by hux17232

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									 TRICARE Dental Program and
TRICARE Retiree Dental Program
      Panel Discussion
    TDP and TRDP Panel Discussion
   Introductions

   TRICARE Dental Program (TDP)
       United Concordia Companies, Inc. (UCCI)


   TRICARE Retiree Dental Program (TRDP)
       Dental Plan of California (Delta)


   Open Discussion
Panel Participants
TRICARE Dental
   Program
   Vice President and
  TDP Program Manager
            TRICARE Dental Program (TDP)


   Offered by the Department of Defense through the
    TRICARE Management Activity (TMA)
   Provides worldwide dental coverage to family members of
    all active duty uniformed services personnel and National
    Guard/Reserve members and /or their families
   United Concordia administers and underwrites the TDP for
    TMA
                   TRICARE Dental Program
                      “Next Generation”


   April 2005 -- United Concordia awarded the TDP contract for the third
    consecutive time
   Enrollment Packet (benefit brochure, enrollment application) – 840,000
    mailed to all eligible (not enrolled) in Oct 2005
   TDP Identification Card – 1.7 million mailed to all enrollees in Nov 2005
   TDP Benefit Booklet -- mailed to enrollees, POCs, OCONUS MTFs
    and DTFs, TAOs, OCONUS BCACs in Jan 2006
   TDP Website -- www.TRICAREdentalprogram.com
   Feb 1, 2006 – “next generation” TDP begins
         TDP CONTRACT OBJECTIVES


   Increase overall TDP enrollment and increase
    utilization of diagnostic and preventive services


   Increase enrollment of National Guard and
    Reserve members in pay grades E-1 to E-4
                     TDP BENEFIT CHANGES
                        Effective Feb 2006
BENEFIT          CURRENT CONTACT   2006 CONTRACT
Bicuspid            Covered        Not covered
Sealants

Implants and         Not covered   Implants and related prosthetics
Implant Prosthetic                 covered
Services


Full Mouth           Not covered   Covered once per 24-month
Debridement                        period.

Frenectomy           Not covered   Covered

Annual maximum        $1200         $1200
Lifetime Ortho        $1500         $1500
                   DENTAL IMPLANTS

   Covered benefit as of 2/1/06


   Covers both the Implant and the Crown placed on the
    Implant


   Subject to the $1200 annual maximum


   OCONUS -- must submit NARF for Implant to be eligible.
                     TDP MONTHLY PREMIUM
                   (Rates Effective 2/1/06 – 1/31/07)

Shared Premium                                 Single   Family
      Selected Reserve Member                 $10.51

      IRR – Spec Mob Category                 $10.51
      Active Duty Family or Family of         $10.51   $26.27
       Reservist on Active Duty orders for
       more than 30 days


Full Premium
      IRR – Other than Special Mobilization   $26.27
       Category
      SELRES & IRR Family Members             $26.27   $65.68
                   National Guard/Reserve
                E1 – E4 Enrollment Project
   TDP contractual objective to increase enrollment
   Quality Improvement Program (QIP) project
       Goal: increase enrollment by 70% in option year 1
       Demonstration Sites (San Diego, San Antonio, Hampton
        Roads/VA Beach)
            Informational postcard w/ floss card to over 12,000 eligible but not
             enrolled
            Toll-free telephone number
            Dental Benefit Advisor (DBA) briefings in conjunction w/ mailing
       Other initiatives include: print ads, posters for each unit, DBA
        survey, Enrollment and Billing telephone survey
                                             TDP ENROLLMENT
                                       Active Duty & AGR                          RC Sponsors                      RC Family
        1800000

        1750000

        1700000

        1650000

        1600000

        1550000

        1500000

        1450000

        1400000
                    Feb-05   Mar-05      Apr-05   May-05     Jun-05     Jul-05    Aug-05     Sep-05    Oct-05    Nov-05     Dec-05     Jan-06
RC Family           59,623    60,085     61,963    66,329    68,672     70,179     70,477    69,567    68,871     70,159     70,132    75,962
RC Sponsors         41,601    41,912     43,283    44,618    45,778     46,070     46,516    46,548    46,721     46,386     47,153    49,271
Active Duty & AGR 1,643,485 1,646,738   1,651,957 1,652,423 1,656,072 1,655,018   1,649,794 1,650,499 1,649,606 1,643,624   1,649,162 1,650,651
                             TDP Provider Network Growth

                    80,000




                                                                                                                                            75,893
                    70,000




                                                                                                                        74,441
                                                                                                    72,434
                                                                                67,876
                                                            65,856
                    60,000              63,964
  Total Providers




                                                                                                                                   57,782
                                                                                                               56,572
                    50,000




                                                                                           54,863
                                                                       53,435
                                                   51,667
                               49,938




                    40,000
                    30,000
                    20,000
                    10,000
                        0    1-Jan-2001          1-Jan-2002          1-Jan-2003          1-Jan-2004          1-Jan-2005          1-Jan-2006
Individual Providers           49,938              51,667              53,435              54,863              56,572              57,782
All Locations                  63,964              65,856              67,876              72,434              74,441              75,893
               PROVIDER NETWORK

   Network Access: Gen dentist, 35 driving miles, 21
    days

                          Required          Actual
    01/31/02               97.0%             98.8%
    01/31/03               97.5%             99.2%
    01/31/04               97.5%             99.6%
    01/31/05               97.5%             99.2%
    02/01/06               99.0%             99.3%
                                         TDP Claims Processed
                                            within 14 Days

                                                   Processed                  Goal
  100%



   95%



   90%



   85%



   80%



   75%
            Dec-04   Jan-05   Feb-05   Mar-05   Apr-05   May-05   Jun-05   Jul-05   Aug-05   Sep-05   Oct-05   Nov-05   Dec-05
Processed   98.9%    98.2%    99.0%    98.3%    98.1%    98.0%    98.6%    98.4%    98.4%    98.4%    98.5%    98.7%    98.5%
Goal         90%      90%      90%      90%      90%      90%      90%     90%       90%      90%      90%      90%      90%
                                TDP Customer Service
                               Average Speed to Answer
                                                  Seconds                  Goal
   35

   30

   25

   20

   15

   10

       5

       0
           Dec-04   Jan-05   Feb-05 Mar-05 Apr-05 May-05 Jun-05   Jul-05    Aug-05   Sep-05   Oct-05   Nov-05 Dec-05
Seconds      3        5        3      4      4      4       4       6         5        4        3        4      1
Goal         30       30      30     30      30     30      30     30         30      30        30      30      30
                                    TDP Telephone Inquiries
                                   Serviced within 30 Seconds
                                                                Inquiries               Goal
  98%


  96%


  94%


  92%


  90%


  88%


  86%
            Dec-04    Jan-05     Feb-05     Mar-05     Apr-05     May-05    Jun-05   Jul-05   Aug-05   Sep-05   Oct-05   Nov-05   Dec-05
Inquiries   95.4%     93.3%      94.9%       95.1%      94.9%      94.1%    95.1%    93.6%    93.8%    94.9%    96.5%    94.5%    97.3%
Goal         90%       90%        90%        90%        90%         90%     90%      90%       90%      90%      90%      90%      90%

    *As of Feb. 2001, Includes Customer Service and Enrollment & Billing
                            ENROLLEE
                     SATISFACTION SURVEY 2005


                                            September   October   November
Network Access                                90%        94%        92%

Claims Processing                             95%        96%        96%

Customer Service                              85%        89%        83%

Enrollment Process                            92%        90%        95%

Size & Quality of Network                     90%        91%        89%

Composite Score
                                              90%        92%        91%
    % rating good, very good or excellent
                        HURRICANE KATRINA
                            RESPONSE

   Implemented toll-free Katrina hotline for TDP enrollees and dentists
        (1-866-TDP-FORU; 1-866-837-3678)
   Suspended premium collections for direct bill enrollees in arrears
   Eliminated “network compliance” barriers. Displaced enrollees will
    not incur additional out of pocket expense if forced to seek “out of
    network” care
   Eliminate “double jeopardy” of co-payments for crowns and bridges
   Suspend specific benefit limitations to enable reestablishment of lost
    dental records
                                       Dental Benefit Advisors
   AK         Ty Obenoskey                                                                                       Richard Panepinto
              Ph. 530-477-9033                                                                                   Ph. 850-995-9024
              ty.obenoskey@ucci.com                                 Debra Stout Ph. 937-324-4456                 richard.panepinto@ucci.com
                                                                    debra.stout@ucci.com                                   NH
                                                                                                                      VT
                        WA                                                                                                        ME
                                              MT               ND
                                                                            MN                           W. PA                         MA
                     OR                                                                WI                             NY
                                 ID                            SD                                                                     RI
                                                                                                  MI
                                                WY                                                                                  CT
                                                                            IA                                      PA       NJ
                                                                 NE                                     OH                        DE
                          NV                                                            IL       IN
                                      UT                                                                      WV                  MD
                                                   CO                                                               VA
                  CA                                                KS           MO                    KY                         DC
Rick Melrose                                                                                                        NC
Ph. 619-749-1781                                                                                  TN
                                                                       OK                                                       Janice Taylor
rick.melrose@ucci.com             AZ               NM                             AR                             SC
                                                                                                                                Ph. 757-481-5003
               HI                                                                           MS    AL        GA                  janice.taylor@ucci.com
     GU                                                           TX              LA
                      Yuma, AZ                                                                                               VI

                                                                                                                   FL               PR
                                                                                                      W. FL
                                           El Paso, TX
                    Annette Verna
                    Ph. 480-706-0110
                    annette.verna@ucci.com               Allan Berrier             Richard Panepinto
                                                                                                                           Isaiah Edwards
                                                         Ph. 210-493-8138          Ph. 850-995-9024
                                                                                                                           Ph. 904-998-7244
                                                         allan.berrier@ucci.com    richard.panepinto@ucci.com
                                                                                                                           isaiah.edwards@ucci.com
                       TDP Contacts

   (TDP Program Manager)
       717 260-7272
   (TDP Marketing and Outreach)
       717 260-6934
   TRICARE Retiree
    Dental Program

Director, Federal Marketing, Delta Dental
    TRICARE Retiree Dental Program
   History
       Early 1980s – Demand for retiree dental program
       1997 – Legislation for retiree dental program
       1998 – Basic Program Implemented
       2000 – Enhanced Program Implemented
       2003 – New Contract Implemented
       2004 – Reached 750,000 Covered Lives
       2005 – Reached 900,000 Covered Lives
       2006 – Still Growing
    TRICARE Retiree Dental Program
   Eligibility
       Members of the Uniformed Services who are entitled to retired
        pay.
       Members of the Retired Reserve (including those under age of
        60).
       Eligible dependents of a member described above who is
        enrolled in the program or if not enrolled certain criteria are met.
       Unremarried surviving spouse and eligible child dependents of a
        deceased member.
       Recipients of Medal of Honor and their eligible family members.
    TRICARE Retiree Dental Program
   Legislative/Regulatory/Contractual
    Requirements
       100% of the premium paid by enrollee
       Premium deducted from retired pay if available
       Service area limitation
       Benefit coverage
       12-month initial enrollment
    TRICARE Retiree Dental Program
   Premiums
       Three levels
       Five regions
   Benefits
       Comprehensive benefit
       100/80/60/50
       12-month waiting period for crowns, prosthetics and orthodontics
        (waiver)
       Orthodontics for children and adults
       Accident coverage
       Deductible $50/$150
       Annual maximum $1,200
TRICARE Retiree Dental Program
   Covered Lives as of March 1 each year
    TRICARE Retiree Dental Program
   Retention
     Year Enrolled   % Retained to Date
         1998               68.8%
         1999               74.2%
         2000               77.3%
         2001               83.2%
         2002               84.8%
         2003               89.2%
         2004               94.3%
         2005               98.0%
    TRICARE Retiree Dental Program
   Covered Lives as of January 1, 2006




                916,737
TRICARE Retiree Dental Program
    Projections for 2006
    1,050,000



                                                                         1,000,000
    1,000,000




     950,000




     900,000




     850,000




     800,000
                Mar- Apr- May- Jun-   Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun-   Jul-   Aug- Sep- Oct- Nov- Dec- Jan-
                 05   05   05   05     05   05   05   05   05   05   06   06   06   06   06   06     06     06   06   06   06   06   07
    TRICARE Retiree Dental Program
   Customer Satisfaction
     100.0%                                                                                                                                                                                       97.7%                               96.6%
                         94.6%

                                                          88.6%                           87.3%                             88.7%
     90.0%                                                                                                                                                      85.8%


     80.0%


     70.0%


     60.0%


     50.0%


     40.0%


     30.0%


     20.0%


      10.0%


      0.0%
              Overall satisfaction with Delta   Recommend Delta to family or   Number of network dentists to   Overall satisfaction with coverage   Satisfaction with overall costs   Overall satisfaction with dental   Satisfaction with overall customer
                           Dental                        friend                        choose from                          provided                           incurred                     claims processing                          service
    TRICARE Retiree Dental Program

   TRDP Network Providers (Dec 31, 2005)
       Individual Dentists – 61,695
       Dentist Locations – 95,269

   Increase of over 20% in provider locations in last
    two years
    TRICARE Retiree Dental Program
   Marketing and Outreach
       Educate and motivate
       Direct contact with retirees, installation contacts,
        retiree councils and retiree associations

       Get the word out
    TRICARE Retiree Dental Program
   Issues
       Increased benefits, decreased premiums
       Government cost-share the premium
       Full coverage of posterior composites
       No waiting periods
       Coverage for implants and implant associated procedures
       My dentist does not participate
       Expansion of program to OCONUS
    TRICARE Retiree Dental Program
   Conclusion
        Enrollment is growing
        Customer satisfaction is high
        The program is a success


    However, we will continue to work to improve the
    program and ensure that those eligible are aware of the
    program and understand its benefits
                   TRDP Contact

   (Director, Federal Marketing)
       916 861-2305
  Open Forum for
  Questions and
    Discussion

Dental Care Division, TMA

       (703) 681-0039

								
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