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The Virtual Blue plans give members (small and large groups) the choice of virtual or in-person care. Virtual care includes $0 unlimited visits to primary care, behavioral health and specialty care through a new partnership with AccoladeCare. In-person care is available through the Tandem PPO network in California and via BlueCard when outside of the state.
The two Virtual Blue small group plans available in PRISM are the Virtual Blue Gold Tandem PPO 1500/45 and Virtual Blue Bronze Tandem PPO 7500/75. These can be identified by ‘Virtual Blue’ in the plan name.
When using the PRISM filter options for Narrow or Broad networks, select ‘All’ networks instead of ‘Broad’ only networks to generate plans for Blue Shield’s Virtual Blue, Trio HMO, and Tandem PPO plans.
If you need assistance, please contact our Quotes team at firstname.lastname@example.org or 800.696.4543.Login To Prism
To help employers keep dental benefits pricing down and alleviate the financial burden of oral care, it’s best to plan ahead and make sure your clients understand all the options that best fit their needs. Below are some factors for employers to consider.
Dental plans have service classes that dictate how much insurance covers specific procedures. These classes are diagnostic and preventative (e.g., teeth cleanings and X-rays), basic (e.g., fillings and root canals), major (e.g., crowns and dentures), and orthodontic (e.g., braces). Diagnostic and preventative services are often covered in full, meaning there will be no out-of-pocket costs. Major and orthodontic services are typically the most expensive out-of-pocket procedures.
Premiums and deductibles must also be factored in. Typically, the higher the premium, the higher the level of coverage for basic, major, and orthodontic services. A deductible is what is required to pay for dental services before the benefits provider will pay. If the plan also covers employees’ family members, a family deductible will have to be paid.
What are the employees’ dental needs, as well as those of family members who will be on the plan? Are there children who need braces or play sports that bring a higher risk of mouth injuries? Does anyone have a history of dental issues (e.g., gum disease, tooth sensitivity, cavities) or need major dental work, such as a crown? These circumstances may require a more comprehensive plan with a higher level of coverage for basic, major, and orthodontic services. On the other hand, if good dental health is maintained, a basic plan may be all that is needed.
After a plan(s) is selected, determine if it will fit your client’s budget and the needs of their employees and their families, and examine any limitations in coverage. Dental plans usually have an annual maximum, which is the most amount of money your insurance will pay in a policy or calendar year. While many people don’t go over the limit, it’s important to factor it in if anyone has ongoing dental issues or needs major procedures like dental implants. Also, consider whether current dentists are in-network or out-of-network. In-network providers are typically more cost-effective to visit, but a plan with a strong MAC or UCR can make out-of-network dentist visits more affordable. Additionally, certain procedures, such as teeth whitening, may not be covered.
While choosing a dental benefits plan is important, it doesn’t have to be difficult. By learning more about the options available and asking questions, it’ll be easy to offer your clients the best plan(s) for their needs.
Beam offers a range of plan options designed to fit the needs of every employer, including:
Every Beam member receives complimentary Beam Perks. The member welcome kit contains a sonic-powered, smart, electronic toothbrush, custom formulated toothpaste, dental floss, and access to the Beam App and Member Portal.
Beam’s SmartPremiums help groups save up to 15% at renewal. When members use the Beam Brush, the group earns a Beam score. The better the group’s Beam score, the lower the group’s premium at renewal.
Premium reduction occurs at renewal (plan year or calendar year) and is based on the group’s aggregate Beam score, prior year claims data analysis, and changes in dentist reimbursement contracts.
Contact our small group experts at 800.696.4543 or email@example.com.