Dental Product Overview

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Agenda

• Who is DBP? • Who is MorganWhiteGroup (MWG)?• The MWG Dental Plan/DBP Partnership • Dental Product Overview• Underwriting Guidelines and the Quoting Process• The Dental PPO Network• Sales Support Tools/Marketing Materials• Case Installation• Preparing yourself to Sell Dental• Questions and Answers

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Who is DBP?

• Founded in 1984• Turnkey - Dental outsourcing specialist• Private-label focus and philosophy• Headquartered in Rockville, MD• Serving over 3 million members• National PPO network - over 55,000 dentists

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Who is MorganWhiteGroup?

• Founded in 1987• Headquartered in Jackson, Mississippi• Over 15 years experience marketing Voluntary

Dental Plans.• Over $50 Million in Health and Supplemental

Benefits Premium in force.• Over $10 Million in Voluntary Dental Premium.• Provides administration services for over 30

insurance companies.

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Dental Product Overview

• Plan Options• Voluntary and Contributory• Indemnity (Traditional)• Passive PPO• Incentive PPO

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Dental Product Overview

Indemnity Dental Options

• One Plan design available– The Benchmark Plan (MWGI1001)

• No Network - Freedom to utilize any provider• Services paid at the 85th percentile of HIAA

(member responsible for any charges not covered by plan)

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Dental Product Overview

Passive PPO Dental Options

• Two Plan Designs Available – The Open Choice Plan (MWGP1001)– The Opportunity Plan (MWGP1003)

• In and Out-of-Network services covered at the same benefit levels– In-Network members pay only negotiated fees for covered services (no

balance billing)

• Freedom to choose any Dentist• No referrals required for Specialty Care

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Dental Product Overview

Incentive PPO Dental Options• One Plan Design Available

– The Incentive Plan (MGWD1002)

• Covers both In and Out-of-Network benefits– Richer benefits available for In-network services– No balance billing to member In-network

• Freedom to choose any Provider– Maximum member savings In-Network

• No referrals needed for Specialty Care

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Dental Product Overview

Custom Dental Plan Options • Build the plan you need to compete

– Indemnity, Passive PPO and Incentive PPO– Voluntary and Contributory Plans

• Group Qualification: 200+ eligibles• All quote requests come to MorganWhiteGroup at:

robinw@morganwhite.com– RFQ must be accompanied by complete data

requirements

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New Basic Dental PlanUnderwritten by United Healthcare Insurance Company Rated

A+ Superior by A.M. Best

• No Deductible• No Waiting Periods• Out of Network paid at the 85th

Percentile of UCR• $1,000 per person per year

maximum

• Diagnostic and Preventative paid at 90%.– 1 office visit, Exam, 1 set of

bitewing x-rays, and cleaning every six months

• Fillings and Simple Extractions paid at 80%.– One, two, three, and four surface

amalgams and simple extractions

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MorganWhiteGroup Dental PlansPlan Name: The Benchmark

Plan

The Open Choice

Plan

The Oppurtunity

PlanMW Plan Code MWGI1001 MWGP1001 MWGP1003

UW Plan Code I1057 P2603 P2605Plan Type Indemnity Passive PPO Passive PPO

Reimbursement Method In/Out UCR DPO/UCR DPO UCR DPO/DPODiagnostic & Preventive 100 100 100 80 100

Minor Restorative 80 80 80 60 80Endodonitcs 50 50 50 40 50

Periodontics 50 50 50 40 50Oral Surgery 50 50 50 40 50

Ortho (Child Only) 50 50 50 40 50Deductible $50/150 $50/150 $50/150 $50/150 $50/150

Ded waived for D&P Yes Yes Yes Yes YesAnnual Maximum $1,000 $1,000 $1,000 $1,000 $1,000

Ortho Lifetime Maximum $1,000 $1,000 $1,000 $1,000 $1,000Waiting Periods

New Groups: Takeover Groups: No Waiting periods for enrollees & their dependents who were enrolled in employer's prior plan.

Incentive PPO

Major Services 50 50 40

12 months for Endodontics, Periodontics, Oral Surgery & Major Services (all enrollees)

5050

The Incentive Plan

MWGP1002

P2604

DPO Reimbursement based on the negotiated provider fee schedule; UCR Reimbursement based on Usual, Customary & Reasonable (UCR) charge.

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Underwriting Guidelines

Dental Quoting Process• Groups under 200 eligibles/enrolled will be quoted from

your General Agent or directly from MorganWhiteGroup.– Internal MWG Dental Process:

• Direct all rate requests to robinw@morganwhite.com or Fax request to Robin Williams at 1-601-956-1702 or call 1-800-800-1397 or 601-956-2028 ext. 116.

– Data elements needed• Situs zip code• Current Rates (copy of current billing, states and current

enrollment by tier• Effective date of coverage

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Underwriting Guidelines

Quoting Process - 200+ Groups

• Build the plan you need to compete.– Passive PPO, Incentive PPO, Indemnity– Group Qualification: 200+ eligibles

• All quote requests come to robinw@morganwhite.com• Data requirements

• Group Name, Effective Date, and SIC Code• Census File (with age, gender, zip code, and enrollment tier of each employee)• Employer’s Zip Code, Specific Broker Commission Percentage, Whether group is

voluntary or contributory, and Current and Proposed Plan Design(s).• Historic Claims vs. Premium reports (3 years of history)• Underwriting will return a quote via email with in 7 business days.

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Underwriting Guidelines

Quoting Process - 200+ Groups

• All 200+ groups quoted by MorganWhiteGroup – Standard plans and Custom plans

• Underwriting Response will include:– Rate Proposal and Underwriting Confirmation Form (including

Assumptions and Considerations)– Exclusions and Limitations– Custom Benefit Grid (custom plans for groups over 200)

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Case Installation Process

Workflows and FormsWorkflow• Prepare Group Quote• Obtain Group Application• Coordinate Enrollment• Send all Enrollment Materials to MorganWhiteGroup• Distribute Group Policy and Employee Certificates• Dental Claim Forms

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The Dental PPO Network

Network Information• Locating a Network Dentist:

– Toll Free: 877-778-4104– Go to www.mwgdental.com website and touch member services

button. Then dental provider search page

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Sales Support Tools/Marketing Materials

Collaterals and Tools• Product Brochure

– Plan Design grid

• Short Proposal• MWGDental.com Website

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Member Services and Claims

• Dental Claims Address: Morgan White Dental Claims

P.O. Box 30566 Salt Lake City, Utah 84130-0566

• MWG Dental Member Services Number: Toll Free: 877-778-4104

• Locating a Network Dentist:– Toll Free: 877-778-4104– Link from www.mwgdental.com website to members button and

then dental provider button for dental provider search page

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Preparing Yourself to Sell Dental

Tips on Comparing plans• Know your dental terminology• Things to look for in other plans:

– Class shifting– Waiting periods – Annual plan maximums– Plan benefits vs. discounts

• Gather specifics about existing plan– plan design/certificate of coverage– current and renewal rates– claims experience

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Dental Facts and Figures• Do Employees want Dental?

– Yes! Dental is the 2nd most popular ancillary health benefit. 175 Million people in the United States currently have dental coverage.

• Will offering Dental benefit my Employer?– Yes! Through increased productivity. 2.5 Million work days are

lost each year due to dental problems.

• Will the Employer’s Employees benefit from a Dental plan?– Yes! Good oral health promotes good overall health.

Periodontal (gum) disease has been linked to heart disease and low birth weight in babies. A dental benefit encourages total health and well-being for employees.