S1: Dental Insurance

Question 1

Dental Insurance:
How is it issued

Answer 1

issued under group policies instead of individual

Question 2

Dental Insurance has
____ frequency and ____ severity

Answer 2

high frequency and low severity

Question 3

Dental insurance
High frequency & low severity

Answer 3

low loss value so less value in dental as purpose of insurance is to share large losses

Question 4

Dental Insurance:
Tax subsidy

Answer 4

Under US code, tax subsidy if dental is issued as group not individual

Question 5

Induced Utilization

Answer 5

over-utilization of insurance benefit

Question 6

How to address Induced Utilization (2 with description)

Answer 6

1. Benefit design: control on costly service
2. Preauthorization: require approval of insurer before service performed

Question 7

Accumulated untreated conditions and how to control

Answer 7

postpone treatment until available insurance, control by limit of pre-existing conditions

Question 8

External Ant-selection

Answer 8

individuals are aware of personal dental needs. Choose company that benefits them most

Question 9

Pediatric Dental Coverage under ACA (Affordable Care Act) that caused issues

Answer 9

oral and vision required to be covered in all non-grandfathered individual and small group health plans as essential health benefits.

Question 10

Government Role in ACA act for Dental

Answer 10

allows carriers to offer health policies without dental coverage as long as standalone dental plans are made available to insureds.

Question 11

Type Coverage and Examples
1) Diagnostics and Preventative
2) Basic Service
3) Prothetic Coverage
4) Orthodontia

Answer 11

1) Oral Examination
2) Extraction, root canal, wisdom teeth
3) Inlays or Crowns
4) Braces and Retainer