Michigan Public School Employees' Rerement System

MichiganPublicSchoolEmployees'Re7rementSystemFallSeminars2017

LisaEggert,SeniorAccountManager

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•  Provideinforma6ononplanchanges•  Provideyourcostshareforcovereddentalservices•  Highlightthetypeofprovidersthatofferyouthe

bestvalue•  Illustratepaymentexamples•  Showyouhowtogetinforma6on

aboutyourplan•  Demonstrateonlinetools•  Answerques6ons

GoalsforToday

Changeseffec7veJanuary1,2018

•  Introduc6onofa$50perpersondeduc6ble•  Applieswhenservicesareprovidedbyaden6stnotinthe

DeltaDentalPPOnetwork•  Appliestobasicandmajorservicesonly

YourCoinsurance

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DeltaDentalPPOden7st

DeltaDentalPremierornonpar7cipa7ngden7st

Diagnos7candpreven7veservicesTwocleanings,examsandfluoride(toage21)percalendaryear

5% 10%

BasicservicesRestora6veservices

X-rays—5%Fillings—20%Allother—25%

25%Deduc&bleisappliedfor

basicservices

MajorservicesProsthodon6cservicesImplants

50%50%

Deduc&bleisappliedformajorservices

Apre-treatmentes7matesubmiQedtoDeltaDentalallowsyoutolearnaboutyourtreatmentop7ons.

Some7melimitsexist.

YourMaximumsandDeduc7ble

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Annualmaximum(percalendaryear)Appliestodiagnos6candpreven6veservices,basicservices,andmajorservicesbenefits

$1,100

Orthodon7cmaximum(life7memaximum)Appliestoorthodon6cbenefits $1,200

Deduc7bleAppliestobasicandmajorservicesprovidedden6stnotintheDeltaDentalPPOnetwork

$50/person

Yourre7rementsystem’sdentalplanhasacarveoutclauseforCoordina7onofBenefits(COB)whentheplanpayssecondary.CheckouttheLearningCenterforaddi7onalprintedmaterials.

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YourDentalPlanOffersChoices

•  Freedomtochooseanyden6st–  DeltaDentalPPOSM

–  DeltaDentalPremier®–  Nonpar6cipa6ng

•  Plandesignedtoofferthemaximumbenefitwiththelowestout-of-pocketexpensewhenyouuseDeltaDentalPPOden6sts

•  YouwilllikelypaymorewhenyouuseaDeltaDentalPremierornonpar6cipa6ngden6st

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•  ProvidersacceptDeltaDental’sPPOapprovedamountaspaymentinfull—youonlypayyourcoinsurance

•  Nobalancebilling•  Providersarepaiddirectly•  ProvidersabidebyDeltaDental’s

processingpolicies

•  Highestbenefitlevel•  Nodeduc(ble

DeltaDentalPPO(PreferredProviderOrganiza7onProgram)

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DeltaDentalPremier

•  Providerspar6cipatewithDeltaDental,butdonotacceptthelowerDeltaDentalPPOapprovedamount—youpayyourcoinsuranceplusanyaddi6onalamountsfornotusingaDeltaDentalPPOnetworkprovider

•  AllowedtochargethedifferencebetweenDeltaDentalPPOapprovedandDeltaDentalPremierapprovedamounts

•  NobalancebillingbetweentheDeltaDentalPremierapprovedamountandthesubmi_edamount

•  Providersarepaiddirectly•  ProvidersabidebyDeltaDental’sprocessingpolicies•  Deduc(bleappliestobasicandmajorservices

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Nonpar7cipa7ng

•  Providersdonotpar6cipatewithDeltaDentalandwilllikelycostyouthemostmoney—youpayyourcoinsuranceplusanyaddi6onalcostsuptotheprovider’scharge

•  Balancebilling•  Deduc(bleappliestobasicandmajorservices

•  Youmayhavetosubmitclaims

10Source:DeltaDentalPlansAssocia6on,April2017

ProviderComparison

DeltaDentalPremier® 340,500+loca7ons

152,626+uniqueden7sts

•  Youpayyourcoinsuranceplusanyaddi6onalamountsfornotusingaDeltaDentalPPOprovider

•  NobalancebillingbetweentheDeltaDentalPremierapprovedamountandthesubmi_edamount

•  Acceptanceofprocessingpolicies•  Deduc(bleappliestobasicand

majorservices

•  Youpayyourcoinsuranceplusanyaddi6onalamountsuptotheprovider’scharge

•  Balancebilling•  Deduc(bleapplies

tobasicandmajorservices

•  Youonlypayyourcoinsurance•  Nobalancebilling•  Acceptanceofprocessingpolicies•  Nodeduc(ble

DeltaDental

DeltaDentalPPOSM

269,800+loca7ons104,467+uniqueden7sts

Nonpar7cipa7ng

MajorServices(crown)PaymentExample(WithDeduc7ble)

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Providertype Charge Approvedamount

Membercostshare

Youpay

Deduc7bleCoinsurance

(PercentofDeltaDentalPPOapproved)

Addi7onalcost

DeltaDentalPPOden7st $950 $675 $0 + $168.75

(25%of$675) + $0 $168.75

DeltaDentalPremierden6st $950 $898 $50 + $156.25

(25%of$625*) + $223** $429.25

Nonpar6cipa6ngden6st $950 $950 $50 + $156.25

(25%of$625*) + $275*** $481.25

*DeltaDentalPPOapprovedamountminusthe$50deduc6ble**DifferencebetweentheDeltaDentalPPOandDeltaDentalPremierapprovedamount***DifferencebetweentheDeltaDentalPPOapprovedamountandnonpar6cipa6ngden6stcharge

Diagnos7candPreven7vePaymentExample(WithoutDeduc7ble)

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Providertype Charge Approvedamount

Membercostshare

Youpay

Deduc7bleCoinsurance

(PercentofDeltaDentalPPOapproved)

Addi7onalcost

DeltaDentalPPOden7st $90 $55 NONE + $2.75

(5%of$55) + $0 $2.75

DeltaDentalPremierden6st $90 $77 NONE + $5.50

(10%of$55) + $22* $27.50

Nonpar6cipa6ngden6st $90 $90 NONE + $5.50

(10%of$55) + $35** $40.50

*DifferencebetweentheDeltaDentalPPOandDeltaDentalPremierapprovedamount**DifferencebetweentheDeltaDentalPPOapprovedamountandnonpar6cipa6ngden6stcharge

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Formoredetailedinstruc7on,visitthe

LearningCenterforademo.

FindingaProvider

Choosethenetwork

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Formoredetailedinstruc7on,visitthe

LearningCenterforademo.

FindingaProvider

Formoredetailedinstruc6on,visittheLearningCenterfora

demo.

Choosethespecialty

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ConsumerToolkit®SecureOnlineAccess24/7

•  Verifyeligibilitystatus

•  Confirmaddress

•  Accessbenefitoverview

•  View/printEOBs

•  PrintpersonalizedIDcards

•  Checkannualmaximumusedtodate

•  Readoralhealthinforma6on

•  SignupforelectronicEOBs

ExtranetSite

ThelinktothistoolislocatedontheOfficeofRe7rementServiceswebsiteunderdentalbenefits.Itcanalsobeaccesseddirectlyat:hQp://www.deltadentalmi.com/MPSERS•  Accessspecificinforma6onaboutyourre6rementsystem

dentalplan•  Accesswri_enplandocumenta6on•  Viewthispresenta6on•  Searchtheden6stdirectoryforaprovider•  LinktotheConsumerToolkit

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MobileSmartphoneApp

•  Verifyeligibilityandbenefits•  Findaden6st•  ViewIDcard•  UsetheToothbrushTimer

AvailableforAppleiOSorAndroidusers.VisittheAppStore(Apple)orGooglePlay(Android)andsearchfor‘DeltaDental.’Or,scanthisQRcodetodownloadtheapp.

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VisittheLearningCenter

•  Askspecificques6onsregardingyourbenefits•  Demothefollowingtools:

– ConsumerToolkit– DeltaDentalPlanofMichiganwebsite– Re6rementSystemextranetpage– Mobileapp

•  Gatherhealthinforma6onflyers

JustforFun•  Thestrongestmuscleinthebodyis……•  Nexttothecommoncold,whatisthemostprevalentdiseaseintheUnited

States?•  WhatcityinMichiganwasthefirstU.S.communitytofluoridateitspublic

drinkingwaterin1945?•  Howmuchspitdoestheaveragehumanproduceinalife6me?•  Howmanymusclesdoesittaketosmile?Tofrown?•  Ifyoudon’tfloss,whatpercentofyourtoothsurfacesdoyoumiss

cleaning?

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Savethatsmile!•  Brushatleasttwiceadaywitha

fluoridetoothpaste•  Flossregularly•  Avoidtheuseoftobaccoandlimitalcohol

toreduceyourriskoforalhealthproblems•  Drinkfluoridatedwater•  Keepupwithregulardentalvisits•  Talktoyourden6stifyouno6ceany

changesorabnormali6es

HealthandWellness

Contac7ngDeltaDental

•  Tollfree:800-345-8756– Advisors

•  Available8:30a.m.–8:00p.m.(EST),Monday–Friday

– DASI(automatedsystem)•  Available24hoursaday,sevendaysaweek•  Providesbenefit,claims,eligibilityinforma6on,DeltaDental’smailingaddressandthenamesofDeltaDentalPPOandDeltaDentalPremierden6stsnearyou

•  www.deltadentalmi.com/MPSERS

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Ques7ons?

09/2017