Aflac Dental and Vision Rates and Renewal Process

Introduction to Aflac Dental and Vision Rates

Presenter: Pete Stan, National Practice Leader for Aflac Dental and Vision
Objective: Discuss characteristics that influence proposed group dental insurance rates for Everwell groups of 3 to 99 participants.

Industry: The nature of the group’s business or service sector can impact rates.
Location: Primarily examined through the group’s ZIP code.
Size of the Group: The number of employees in the group also plays a role in determining rates.

Shelf Rate: A standard rate exists for groups between 25 and 250 employees in most states.
- The shelf rate is applied uniformly to all employees irrespective of their residence state.
- Designed to be neutral in relation to industry type and gender demographics.

Individual vs. Group Rates:
- Individual plans have guaranteed rates based on fixed dollar benefits.
- Group plans are structured with coinsurance percentages, which are subject to change based on provider charging rates that may change due to inflation or technological advancements.
Trend Increase:
- Renewal rate increases are typically around 46%, categorized as trend increases.
Historical Rate Increase Performance:
- Aflac has not delivered a rate increase since the introduction of their group dental plans, attributed to previous operational system challenges.
- With recent improvements and partnerships, Aflac is expected to align with industry standards for renewal rates.

Comparison with Market Trends: Aflac analysis of cumulative industry rate increases over the years guides their strategy.
Actuarial Analysis: The actuarial team assesses claims, commissions, and administrative costs versus premium income per state.
Provider Networks: Higher renewal rates are associated with groups that primarily utilize out-of-network providers compared to those using in-network providers.

Proactive Engagement: Agents should discuss new rates with employers promptly after receiving renewal notifications.
- Agents receive renewal letters 15 days prior to clients to prepare for discussions.
Talking Points for Employer Conversations:
- Informing about the renewal effective date and anticipated slight rate adjustments, typically aligned with industry trends.
- Clarifying impacts on employee payroll deductions and facilitating communication with payroll departments.

Example Rate Adjustment: An expected annual rate increase may amount to a dollar or less per pay.
Historical Rate Stability: Aflac's dental products have not seen any rate increases since acquisition, presenting a competitive edge.
Rate Guarantees and Adjustments:
- Some plans feature a two-year rate guarantee while others, particularly with July 1 effective dates, may see adjustments.

Asset Management Strategy: Implement asset management strategies before initiating open enrollment.
Seamless Transition: During passive renewals, groups retain the same plan design, although rate adjustments may still occur.

Verify Employee Counts: Confirm eligible employee counts in the system before enrollment.
Open Enrollment Period Verification: Ensure open enrollment dates are clearly set and communicated effectively.

Initial Notifications: Accounts receive notification 90 days before the renewal date if they do not meet renewal requirements.
Nonrenewal Requests: Required if an account no longer meets participation criteria, must be submitted on company letterhead.
- Sample documentation is provided for reference within communication.

Minimum Enrollment Criteria: Specific criteria must be met for accounts of various sizes to maintain renewal eligibility:
- 3 to 24 employees: Minimum of 2 enrollees required.
- 25 or more employees: At least 20% participation required.
- Employer-Paid Rates: Requires 100% participation with a minimum of 10 eligible employees enrolled.

Employer Portal Navigation: Employers can perform various tasks through the provided link.
- Key functionalities after logging into the portal: View member population, manage roles, and make payments.
Member Portal Features: Members can access essential functions including:
- Viewing membership information, printing ID cards, and reviewing claims.

Portal Access: Members encountering login issues can use the help features for retrieving usernames and resetting passwords.
Contact Support: Instructions to contact support directly for additional assistance are detailed.

Continuous Learning: Agents are encouraged to become knowledgeable about group dental and vision products through available resources listed on the Aflac site.