Dental
What Should Full Service Really Mean for an ASO Group?
by Gary White

When it comes to dental benefits, self-funded standard administrative services only (ASO) groups often face a difficult decision: Choose a low-cost, third-party administrator that does the bare minimum or go with a large, full service carrier and pay big ASO fees. Fortunately, a few dental carriers out there do provide impressive savings and full service, which allows clients to get more for their self-funded dollar.
These carriers typically provide a full array of services. When selecting one of these carriers, be sure the fees cover everything groups need to make their dental benefit plan a success, including the following:
• Support and world-class service from enrollment through claims.
• Customized enrollment materials, on-site support, and printing and mailing of ID cards.
• Eligibility loading, sharing, and maintenance (including history load, cross checks and coordination of benefits.)
• Explanation of benefits (EOBs) mailed directly to employees’ homes.
• Billing via automated clearinghouse or paper.
• Electronic or paper claim submission.
• Network management and access, and targeted recruiting.
• Timely performance reporting to ensure that you are receiving top value. Standard reports include claims and enrollment, cost containment and payment by benefit level.
• Risk management and actuarial services, including funding rates, reserves, and cost projections.
• Hands-on account service from experienced dental executives, including an assigned account manager who can help with enrollment meetings and who is responsible for addressing both the agent’s and the client’s needs.
There are carriers who exceed service expectations with 99% financial and claims accuracy. With plan designs including indemnity, PPO, and consumer driven options, you should be able to find a carrier that can work with consultants and brokers alike on a plan that best meets their clients’ needs.
In addition to ASO contracts, there are several key points to consider when selecting your dental benefits carrier. Select a dental benefits carrier that makes it easy to do business with. Brokers rely on providers who invest in making their jobs easier and their businesses more successful and those who differentiate themselves through excellent service provide optimum value to their clients.
––––––––––
Gary White is the chief sales officer for Securian Dental, based in St. Paul, Minn. Securian Dental is available nationwide and has recently been introduced in Calif. Securian Dental is underwritten by Securian Life Insurance Company and administered by DeCare Dental Health International LLC. DeCare Dental and Securian Dental launched the nation’s first analytically based dental benefit plans. In California, Securian Dental is underwritten by Securian Life Insurance Company, offered through DeCare Dental Insurance Services, LLC, and administered by DDHI Administrators LLC. Contact Gary White at gwhite@securiandental.com or (651) 994-5318.

Considering ASO Contracts

In a standard ASO contract, the group has financial responsibility for the dental plan, and purchases claim processing services from the dental insurance carrier. In general, groups with 100 or more employees might want to consider an ASO contract. They tend to work best for large groups with stable paid claims and those that have had dental coverage for a number of years. Maintaining claim reserves becomes the group’s responsibility.
The advantage is that administrative charges are generally lower for ASO contracts because the group accepts most of the risk. The group is only liable for paid claims and administration, which may be less than the premium required to fund a risk contract in some instances.
   The biggest disadvantage of an ASO contract is the possibility that claims may run higher than expected. The financial risk may be unacceptable to some groups. Fluctuations in claim payments may be disruptive to budgets and cash flow planning.