AARP Dental Insurance Plan
Serving the individual dental insurance needs of the 50+ population
Dr. Lowell Daun
Available dental programs for individuals
• Dental Discount Plans
– Not insurance – Percentage discount for specific dental treatments
• HMO
– Capitation plan – Pre-assigned provider office
• PPO
– Fee-for-Service program – Extensive provider network with providers agreeing to prenegotiated reduced rates – The ability to see an out-of-network dentist at a higher out-ofpocket cost
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AARP Program Accessibility
• Available in 49 states plus DC and Virgin Islands
AARP National Rollout February 1, 2007
Alaska (AK)
DDIC
Washington (WA) DN Oregon (OR)
DN
Montana (MT)
DDIC
North Dakota (ND)
DN
New Hampshire (NH) DNNE Minnesota (MN)
DN
Vermont (VT) DNNE Wisconsin (WI)
DN
Idaho (ID)
DN
South Dakota (SD) Wyoming (WY)
DN DN
Maine (ME)
DN Massachusetts (MA) DNNE
Nebraska (NE)
DN
Iowa (IA)
DN
Michigan (MI) DN
New York (NY)
DDIC
Pennsylvania (PA) Illinois (IL) Indiana Ohio (OH) DN (IN)
DN West Virginia (WV) DDIC DDIC DN
Rhode Island (RI) DN Connecticut (CT) DN New Jersey (NJ) DN
Nevada (NV) California (CA)
DN DDIC
Utah (UT)
DDIC
Colorado (CO)
DN
Kansas (KS)
DN
Missouri (MO)
DN
Kentucky (KY) DN Tennessee (TN)
DDIC
Virginia (VA) DN
Delaware (DE) DDIC Maryland (MD) DDIC Washington D.C. DDIC
Oklahoma (OK) Hawaii (HI) DN Arizona (AZ)
DN
New Mexico (NM)
DN
DN
Arkansas (AR)
DN
Mississippi Alabama (AL) (MS)
North Carolina (NC) DN South Carolina Georgia (SC) DN (GA)
DDIC
Texas (TX)
DDIC
DDIC
DDIC
Louisiana (LA) DDIC Florida (FL)
DDIC
AARP Dental Insurance Plan
Puerto Rico
Green means approved Red means not approved Version date 02.01.07
DDIC
Virgin Islands
DDIC
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Where is the plan most successful?
• California • Florida • New York • Pennsylvania • Texas
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AARP Program Benefit Design
• Choice of two benefit designs • Premium rates range from $38 - $51 monthly for a single person • 2-year rate guarantee • 4 payment options • 12-month waiting period for major restorations, periodontics and prosthodontics • PPO program
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AARP Program Benefit Summary
AARP Dental Insurance Plan Benefit Summary Percentage of Allowed Amount for Plan A Delta Pays* 100%** 80% 80% 50% 50% 50%
50% 50% 50% 50%
Diagnostic & Preventive Periodontal Maintenance Cleanings Denture Repair, Rebase and Relining Basic Restorations & Sealants Oral Surgery Endodontics Major Restorations (e.g., crowns, inlays/onlays) Periodontics (gum disease treatment) Prosthodontics (bridges & dentures) Temporomandibular Joint Dysfunction (TMJ)
Percentage of Allowed Amount for Plan B Delta Pays* 80% 50% 50% 50% 50% 50%
50% 50% 50% 50% $100 $1,000 $300
After 12 Months Continuous Enrollment
Deductibles and Maximums Per Enrollee
Calendar Year Deductible $50 Calendar Year Maximum Benefit $1,200 Temporomandibular Joint Dysfunction (TMJ) $300 treatment—Lifetime Maximum Additional Benefits Available With Payment at the Annual Rate Level Dental Accident 100% Lifetime Maximum—Dental Accident $1,000
N/A N/A
* Benefit level available only when visiting a Delta Dental PPO dentist. ** No deductible required for diagnostic or preventive services under Plan A.
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Who purchases this plan?
• Individuals 50 and over, such as:
– Retirees without dental benefits – Working adults without employer-sponsored benefits
• Typical psychographics:
– – – – – – Affluent in terms of household income and net worth Well-educated Aged 60-75 Female Married Financially savvy, like to shop, technically savvy, live the fine life
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What makes this population different?
• Lack of availability to true private dental insurance
– Less than two out of every ten older Americans are covered by private dental insurance (DHHS ―Oral Health in America – 2003) – No more than 20% of Americans 75 years of age and over have dental insurance (Centers for Disease Control and Prevention – 2005) – Oral Health America gave the nation on average a final grade of a ―D‖ for private dental coverage in a special grading report on ―The oral health of Older Americans‖ (Oral Health in America – September 2003)
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Comparable dental programs
• Only one other individual/voluntary program is available to this population: TRICARE Retiree Dental Program
– Department of Defense contract for retired military and their eligible dependents, administered by Delta Dental – Very similar to AARP Dental Insurance Plan’s benefit structure with comprehensive coverage – 100% voluntary, premiums paid by the enrollee
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Key elements of a successful dental plan
• Understanding the needs of the senior market
–Comprehensive coverage –Affordable price –Network size –Quality of network dentists
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Marketing channels
• Direct Mail
– to current AARP members
• Print Advertising
– in AARP publications
• Online Advertising
– aarp.org and other sites of interest to seniors
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What else do they want?
• Third cleaning • Implants • No waiting periods • Increased maximums
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Program Administration
• Administrative Requirements
– More complex than with the traditional commercial client
• • Call volume Regulatory requirements
• Enrollment Rollout
– Original forecasts assumed all states approved by September 2004 – Many key states (including CA, FL, NJ, NV, & WA) were not available until early 2005 – As of June 2007, the only remaining state is MA
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Program Utilization
• The first members to join the plan were the most costly members • Once the demand was met, the experience and needs were more favorable • Maximum Utilization
– First year members rarely reach their annual maximum – Once full benefits are reached, the number of members reaching their maximum increase towards normative levels – Utilization is remaining higher than expected overall
• Procedures being used are closely resembling Delta Dental’s Commercial experience with this demographic
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AARP Program Results to Date
• As of June 2007
– 182,222 total members
• Most successful product launch among AARP Healthcare Option (HCO) products • Highest requested product among HCO products in 2005—2006
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Innovations
• Plan designed with the senior market in mind
–Periodontal maintenance cleanings and denture repair 1st year benefits
• Expanded benefits under consideration
–Third cleaning –Implants
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AARP Dental Insurance Plan Contact Information
• Toll free: 1- 866-583-2085
• Web site: www.deltadentalins.com/aarp
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