Graduate and Professional Dental and Vision Q&A August 28, 2018 - - PowerPoint PPT Presentation

Graduate and Professional Dental and Vision Q&A

August 28, 2018 Hosted by: Graduate Student Assembly Graduate and Professional Student Senate

Your Representatives: Ed Courchaine & Jenette Creso

Advocacy Committee Chairperson Facilities and Healthcare Chairperson

Session Overview:

• Current Plan information

○ Vision Plan ○ Dental Plan

• FAQs Overview
• Alternative Options for Care
• History of GSA and Senate Work

Current Plan Information

Enrollment Period

For both Dental and Vision Coverage:

Enrollment Period: August 15th - September 15th Coverage Begins: October 1st

EyeMed Vision Plan

2018-2019 Annual Premiums

Individual $82.20 Individual + 1 $156.34 Individual + Family $229.53

EyeMed Vision Plan

Plan Benefits (In-Network)

Exam with Dilation (yearly) $25 co-pay Lasik or PRK from US Laser Network 15% off retail, 5% off promotional rate Frames (yearly) $0 co-pay $160 allowance 20% off remaining balance

EyeMed Vision Plan

Plan Benefits (In-Network)

Standard Plastic Lenses Single Vision $15 co-pay Bifocal $15 co-pay Trifocal $15 co-pay Standard Progressive Lens $80 Premium Progressive Lens $80, 80% of charge less than $120 allowance

EyeMed Vision Plan

Plan Benefits (In-Network)

Lens Options UV, Tint, Standard Scratch Coating $15 Standard Polycarbonate $40 Standard Anti-reflective Coating $45 Polarized Lens, Other Add-Ons 20% retail price

EyeMed Vision Plan

Plan Benefits (In-Network)

Contacts Lenses (yearly) Standard Lens Fit and Follow-up Up to $40 Premium Lens Fit and Follow-up 10% retail price

EyeMed Vision Plan

Plan Benefits (In-Network)

Contacts Lenses Conventional $0 co-pay, $130 allowance, 15% off remaining Disposable $0 co-pay, $130 allowance, 15% off remaining Medically Necessary $0 co-pay, Paid-in-Full

EyeMed Vision Plan

Important Note:

Member ID: An ID card will be mailed to you. Alternatively, the UPI number that is found

• n your Yale Student ID card can be used to

generate an online EyeMed account where you can access your member ID number.

Delta Dental Plan

Vocabulary:

• PPO (Prefered Provider Organization) vs Premium Provider

PPO dentists have agreed to lower patients costs, however, there are less dentists in the PPO network than the Premium Network. ~45% of dentists are PPO, ~80% are Premium

• Deductible = how much you pay for a claim
• Maximum = annual amount Delta will pay for treatments

Delta Dental Plan

2018-2019 Annual Premiums

Individual $227.64 Individual + 1 $402.84

Delta Dental Plan

Plan Benefits (Year 1)

PPO Premium Preventative and Diagnostics 100% 60% Fillings n.a. n.a. Deductible n.a. $35 Maximum n.a. n.a.

Delta Dental Plan

Plan Benefits (Year 2+)

PPO Premium Preventative and Diagnostics 100% 60% Fillings 80% 50% Deductible $25 $35 Maximum $1000 $1000

Delta Dental Plan

Important Notes:

Pay attention to who you are booking a dental appointment with if you want to pay the PPO price! The same dental office can have both PPO and Premium Dentists.

Delta Dental Plan

Important Notes:

Member ID: An ID card will NOT be mailed to you. The UPI number that is found on your Yale Student ID card can be used to generate an

• nline account where you can request a card.

FAQs

Does my coverage stop if I graduate?

No!

After you have bought insurance, you are covered from October 1, 2018 through September 30, 2019.

What do I do if I need to use my dental plan

• utside of New Haven?

Visit www.deltadentalct.com and use Delta Dental’s dentist search to find a participating dentist near your location. Both networks (PPO and Premium) are available in all states.

Do I get the fillings benefit if I take a year off from the dental plan?

No. To receive the fillings benefit, you must be in your second year of continuous coverage.

What if I change my mind after enrolling? Can I get a refund? If I miss enrollment, is there another time I can enroll in the plan?

Once the enrollment window closes, you will not be able to enroll in the graduate dental plan until the following year. If you have already enrolled, you are covered through September of 2019, no refunds will be given.

Alternative Options for Care

Individual Plans

Delta Dental offers individual plans starting at $36.89 (basic) or $75.54 (premium) a month; $442.68 or $906.48 annually Basic does not include any coverage for crowns, root canals, implants, etc.

Basic Premium Preventative and Diagnostics 100% 100% Fillings 50% 80% Deductible none $35 Maximum $1000 $2000

Local Dental Offices

Can go to local dentists without insurance! Some local dentists offer discounts for people without insurance and for students Local dentist price variations:

Low High Exam cleaning and X-rays (first visit) $57 $432 Exam and cleaning $88 $209

Yale-New Haven

Yale-New Haven Dental Services offers a 55% discount for self-paying patients

With discount Full mouth x-rays $78.75 Exam (1st visit/ further visits) $50.85/ $32.40 Cleaning (1st visit/ further visits) $57.15/ $25.71 Bitewing x-rays $38.25

UConn Dental School

UConn Dental School offers deep discounts for appointments made with trainees at a state-of-the-art dental facility in Farmington, CT.

Discount Time of Procedure (relative to private practice) Student Clinics 75-80% 2-2.5x Resident Clinics 40-50% 1-1.5x Faculty none 1x

History of GSA and Senate Work on Dental

A brief timeline...

• 2010 - G&P Dental Plan begins as a preventative and diagnostic plan only
• 2013 - 80% filling benefit is added
• 2016 - 12 month waiting period for filling benefit introduced

From 2010 to 2018 the cost has risen from $140 to $227 for a single student. Enrollment has fluctuated between 1950 and 1480 students. Dental subsidies are not unprecedented: the post-doc plan is ~30% subsidized

GPSS and GSA Strategy for Improving Dental

Two major thrusts: 1. Research alternative care providers 2. Lobby the Yale administration for more staff and financial support

Alternative Care Providers

• Alternate Insurer: At this time, Delta is the only insurance provider who

will talk with us

• Local Insurance Plan: In 2016 we polled regional dentists for interest in a

local plan for Yale G&P students. Interest was low to non-existent.

• UConn Dental School: In 2017 we attempted to formalize a relationship

with the UCDS but communication abruptly stopped, leaving a dead end.

• YNHH Dental: We are engaged in an ongoing conversation with the

YNHH Dental residency program.

Obtaining more support from Yale

• Fact Finding with Yale Health: In 2016-2017 Yale Health researched

alternate payment structures that might reduce costs.

• Aid Plan Negotiations: In 2018 we requested professional help from HR

to secure better terms for the plan including a waiver for the 12 month wait period and a mid-year enrollment option.

• Increased Administrative Support: Also in 2018 we requested more

staff time for administering the plan to reduce the burden on unpaid GPSS and GSA volunteers.

Going forward..

1. We will be looking for explanations for why the assistance we were told would come did not arrive or produce tangible outcomes this year 2. We will continue updating the information available on local dentists to help you make decisions about your own dental needs. 3. We will summarize the cost to provide dental insurance to all G&P students at Yale, and lobby for that financing

What you can do:

Take care of your teeth!

What you can do:

Take care of your teeth!

Be a proactive patient: ask what a procedure will cost before you get it, check what network the dentist participates in, and research all your options. Contact us via the GPSS or GSA websites, gradprofdenteye@yale.edu, or our personal emails addresses to tell us what you think about dental care at Yale. jenette.creso@yale.edu edward.courchaine@yale.edu

Q&A/Discussion

Any questions or comments?

Thank you!

gpsenate.yale.edu gsa.yale.edu gradprofdenteye.yale.edu