DENTAL PLAN UPDATE Dollar Cost and Reimbursement Comparison March - PowerPoint PPT Presentation

Mark III Employee Benefits DENTAL PLAN UPDATE Dollar Cost and Reimbursement Comparison March 31, 2016

Dental Plan Mark III Employee Benefits Ameritas Options: • Option 1 saves the Town $6,995.04. • Option 2 increases the Town cost by $708.00. • Option 3 increases the Town cost by $3,879.84. • There is a substantial improvement in the reimbursement with Option 3. • Given the savings on the Medical Plan, Option 3 remains the recommendation for the Dental Plan for 2016 – 2017. 2

Dental Mark III Employee Benefits Town of Nags Head - Dental Reimbursements Prepared by: Mark III Employee Benefits - March 2016 Always Care Ameritas Ameritas Description ADA Code MAC 75th UCR 90th UCR Cleanings D1110 $65.00 $87.00 $93.00 Exams D0120 $31.00 $49.00 $53.00 Bitewing X-Rays D0272 $29.00 $43.00 $48.00 Non-Surgical Extraction D7140 $106.00 $162.00 $184.00 Resin filling - 1 surface D2330 $107.00 $150.00 $166.00 Crown D6750 $782.00 $1,078.00 $1,163.00 Change in Premium N/A 1.9% increase 10% increase Based on Zip Code 27959 • There is a substantial improvement in the reimbursement with Option 3. 3

Dental Mark III Employee Benefits AlwaysCare - Current Ameritas - Option 1 In-Network Out-of-Network In-Network Out-of-Network Preventive Preventive Preventive Preventive Cleanings 100% 100% 100% 100% Exams 100% 100% 100% 100% Fluoride Treatment 100% 100% 100% 100% Space Maintainers 100% 100% 100% 100% X-Rays 100% 100% 100% 100% Sealants 100% 100% 100% 100% Basic Basic Basic Basic Fillings 80% 80% 80% 80% Oral Surgery 80% 80% 80% 80% Major Major Major Major Periodontics 50% 50% 50% 50% Endodontics 50% 50% 50% 50% Crown & Bridge Repair 50% 50% 50% 50% Denture Repair 50% 50% 50% 50% Crowns 50% 50% 50% 50% Bridges 50% 50% 50% 50% Dentures 50% 50% 50% 50% Implants 50% 50% 50% 50% Annual Deductible (Does not $50 (3 X Family) $50 (3 X Family) $50 (3 X Family) $50 (3 X Family) apply to preventive services) Annual Maximum $1,500 ($2,750)** $1,500 ($2,750)** $1,500 ($2,500)*** $1,500 ($2,500)*** $150 Annual bonus if PPO provider is used Orthodontic Orthodontic Orthodontic Orthodontic Child Only Child Only Child Only Child Only Orthodontics 50% 50% 50% 50% Orthodontic Lifetime Maximum $1,000 $1,000 $1,000 $1,000 Waiting Periods None None Rate Guarantee Until 7/1/17 1 year Premium Stabilization Reserve No Yes In - Negotiated Fee In - Negotiated Fee Claim Reimbursement Out - MAC Out - Negotiated Fee Monthly Rates Monthly Cost Monthly Cost Employee 47 $26.98 $1,268.06 $22.04 $1,035.88 Employee/Spouse 21 $58.28 $1,223.88 $47.12 $989.52 Employee/Child(ren) 13 $63.68 $827.84 $58.84 $764.92 Employee/Family 37 $102.30 $3,785.10 $83.92 $3,105.04 118 $7,104.88 18% reduction $5,895.36 Annual Cost $85,258.56 $70,744.32 Town Annual Cost $38,203.68 $31,208.64 4 Difference N/A ($6,995.04)

Dental Mark III Employee Benefits Ameritas - Option 2 Ameritas - Option 3 In-Network Out-of-Network In-Network Out-of-Network Preventive Preventive Preventive Preventive Cleanings 100% 100% 100% 100% Exams 100% 100% 100% 100% Fluoride Treatment 100% 100% 100% 100% Space Maintainers 100% 100% 100% 100% X-Rays 100% 100% 100% 100% Sealants 100% 100% 100% 100% Basic Basic Basic Basic Fillings 80% 80% 80% 80% Oral Surgery 80% 80% 80% 80% Major Major Major Major Periodontics 50% 50% 50% 50% Endodontics 50% 50% 50% 50% Crown & Bridge Repair 50% 50% 50% 50% Denture Repair 50% 50% 50% 50% Crowns 50% 50% 50% 50% Bridges 50% 50% 50% 50% Dentures 50% 50% 50% 50% Implants 50% 50% 50% 50% Annual Deductible (Does not $50 (3 X Family) $50 (3 X Family) $50 (3 X Family) $50 (3 X Family) apply to preventive services) Annual Maximum $1,500 ($2,500)*** $1,500 ($2,500)*** $1,500 ($2,500)*** $1,500 ($2,500)*** $150 Annual bonus if PPO provider is used $150 Annual bonus if PPO provider is used Orthodontic Orthodontic Orthodontic Orthodontic Child Only Child Only Child Only Child Only Orthodontics 50% 50% 50% 50% Orthodontic Lifetime Maximum $1,000 $1,000 $1,000 $1,000 Waiting Periods None None Rate Guarantee 1 year 1 year Premium Stabilization Reserve Yes Yes In - Negotiated Fee In - Negotiated Fee Claim Reimbursement Out - 75% UCR Out - 90% UCR Monthly Rates Monthly Cost Monthly Cost Employee 47 $27.48 $1,291.56 $29.72 $1,396.84 Employee/Spouse 21 $58.72 $1,233.12 $63.56 $1,334.76 Employee/Child(ren) 13 $72.72 $945.36 $78.80 $1,024.40 Employee/Family 37 $103.96 $3,846.52 $112.64 $4,167.68 118 1.9% increase $7,316.56 10% increase $7,923.68 Annual Cost $87,798.72 $95,084.16 Town Annual Cost $38,911.68 $42,083.52 5 Difference $708.00 $3,879.84

Mark III Employee Benefits