getting started with dental and vision

Aflac Dental and Vision Training Series Overview

  • Presenter Information
    • Name: Jeremy Erb
    • Purpose: To educate on Aflac dental and vision products, processes, and sales strategies.
    • Key Leaders: Pete Stamm, Dave Nagel, Anthony Globb
    • Aim: To offer product education and support to agents.

Introduction to Aflac Dental and Vision Products

  • Importance of understanding how Aflac differs from other dental and vision insurance providers.
  • Goal: Set Aflac apart in the market.

Key Differentiators of Aflac Dental and Vision Plans

Reducing Deductible

  • Definition: A benefit that progressively reduces the deductible paid by the client.
  • Structure:
    • Year 1: $50 deductible per covered person
    • Year 2: Reduces to $25
    • Year 3: $0 copay
  • Condition: Continuous enrollment by the original covered individual required.
  • Benefit: Clients save money annually on their plans.

Maximum Carryover Benefit

  • Definition: A beneficial feature that rewards members based on their claims.
  • Eligibility: Claims do not exceed $500 for the calendar year and submission of at least one qualifying claim is required.
  • Benefit Structure:
    • Qualifying members receive an additional $250 added to the next year's annual maximum.
    • Cap: Benefit limits at $1,000.
  • Example:
    • Fred enrolls and receives an additional $250 due to keeping his claims under $500.
    • Year 1 Max: $1,000; Year 2 Max: $1,250 without an increase in premium.

Out of Network (UCR) Benefits

  • Policy: Members are not restricted to in-network dentists.
  • Benefit Reimbursement:
    • Reimbursed at the 90th percentile of usual and customary charges (UCR) in a location.
    • Further enhanced with state brochure plans to the 95th UCR.

Dental Accidental Injury Benefit

  • Definition: Coverage for treatment resulting from an accident or injury to natural teeth.
  • Key Features:
    • No coinsurance, no deductible, no waiting period, no pre-authorization required.
    • Coverage: 100% coverage to the plan's annual maximum.

Sales Strategy Recommendations

  • Application of Benefits Knowledge: Utilize knowledge of differentiators in sales pitches, as many employers are unaware of these benefits.
  • Marketing Strategies: Share these benefits with existing clients and leverage for new sales opportunities.
  • Billing Practices:
    • Understanding that group dental and vision products are billed upfront rather than after deductions to minimize financial risk.
    • Upfront billing ensures active coverage regardless of employment changes.

Invoicing and Enrollment Details

  • Invoice Process:
    • Group products are billed upfront.
    • One invoice for voluntary employee-owned products and another for group-sponsored products.
  • Enrollment Process Reminders:
    • New invoices are posted on the employer portal with instructions for electronic payments and checking invoice status.

Prospecting and Selling Tips

  • Importance of Dental and Vision Insurance: Dental ranks high among requested benefits, just behind medical insurance.
  • Focus on Smaller Groups: New agents should target smaller groups that may not currently have coverage for building confidence.
  • Vision Insurance Insight: Vision insurance is proposed as a low-cost, high-value benefit that can be offered without hardship.

Provider Network Education

  • Challenges with Network Changes: Educating clients on the flexibility of PPO plans vs. standard network limitations.
  • Competitive Provider Network Info: Stress growth and competitive aspects of the network and recruitment strategies.

Conversation Starters for Brokers

  • Engagement: Begin by asking about current dental and vision carriers for insights.
  • Qualifying Questions: Discuss the size of groups brokers typically quote and the most valued qualities of a dental/vision carrier.
  • Closing Strategy: Always ask for business and referrals after successful engagements.

MAC vs. PPO Plans

  • Definition and Comparison:
    • Both offer identical benefits at in-network dentists.
    • MAC involves lower reimbursement levels for out-of-network services, with a higher probability of out-of-pocket costs.
    • PPO reimburses based on a wider benchmarking (90th percentile).
  • Cost Considerations: Emphasize potential savings with MAC plans while detailing associated risks of higher costs with out-of-network dentists.

Product Offerings

  • Everwell Plans: Available for groups with 3-99 eligible employees (3 dental and 3 vision plans).
  • Brochure Plans: For groups with 25-250 employees; includes 4 dental and 2 vision plans without industry restrictions.
  • Custom Quotes: For groups with over 100 employees, requires specific documentation and underwriting considerations.

Enrollment Best Practices

  • Planning: Importance of preparation and education in ensuring successful enrollments.
  • Participation Requirements: Explanation of minimum enrollments required for plans based on group size.
  • Objections Handling: Addressing barriers such as existing coverage or cost concerns during enrollments.

Underwriting and RFP Process

  • Submission Requirements: Importance of complete and accurate RFP submissions including competitive intelligence.
  • RFP Checklists: Utilize checklists to ensure proper completion and reduce turnaround time.
  • Proposal Follow-ups: Importance of prompt follow-ups to leverage proposal advantages.

Post Enrollment Processes

  • Welcome Packets: Overview of welcome materials for clients post-enrollment, including ID cards and coverage summaries.
  • Member Changes: Processing member life events and terminations efficiently through Everwell.

Conclusion and Future Steps

  • Continuous Education: Encouragement to remain engaged with further training and updates regarding Aflac Dental and Vision products.
  • Support Resources: Reminder to utilize available resources on the One Aflac site for ongoing assistance.