December 3, 2019
So . . . what happened to our health plan in 2019?? Two things mostly. One big thing that didn’t happen.
1. UHC did NOT rate offices as part of a large group.
NDA offices were not being rated as if they were part of a large group, but instead as if they were a small group. In the insurance game, that is a group between 2 and 50 lives. When the early quotes were coming in and didn’t seem that great, I kept asking Aon, are we being rated correctly?? I never received a direct answer, which leads to the second “thing” wrong in 2019.
2. Aon was in the process of downsizing
As the NDA plan was starting to launch in the spring of 2019, corporate Aon was in process of downsizing Aon’s Omaha office. Details are contained in the November posting below.
Jim Garbina with Harry A. Koch spoke to the NDA Board of Trustees during the September meeting about our health plan and agreed to look into what happened and speak to UHC going forward. Jim was able to confirm point No. 1 above. Jim also discovered that Aon not only downsized their Omaha office, they have not service staff in Omaha!
Any Good News?
Yes!! Last spring, we had 147 offices submit surveys which indicated 1,857 potential “insurable lives” in the NDA group. This includes employees, spouses and children. How many "lives" need to be in the Plan to be considered a large group?
When the 2020 Reboot of the Health Plan begins in January next year, we need to reach 500 “lives” in the Plan to be considered a group and receive group rates. We will never reach 500 lives if eligible employees in offices are dentists only. The Reboot timeline is below:
November 17, 2019
Long story below . . . Aon is no longer involved.
For 2020, contact UHC directly. Let them know where you were in the process with Aon (if any) during 2019. Email Bryce Bunde and Cara Groth / Office: (402) 445-5565 / e-mail: firstname.lastname@example.org
The last month has been quite a blur and its not over. Here is a summary that I sent to the Board:
In mid-June, Pat Bourne left Aon to work for Medica Insurance Company. During the summer, we would occasionally get calls that Aon was not responding to some NDA member questions. When I would contact Jerome, he would respond.
August 23, 2019, Jerome Rewolinski leaves Aon with a 4 hour notice email to NDA, “but due to circumstances out of my control, I feel impelled to share my news with you. I made the decision a few weeks ago, to leave my position at Aon.”
September 18, 2019 - Steve Clausen, the VP who oversees the Aon Health and Benefits team, Jody Gilcrest and Michaela Valentin met me at Starbucks for a “touch base meeting.” After reviewing one our member’s quotes, Steve explained that Aon was reorganizing the Omaha office, was having a tough time finding employees and therefore, Aon would not be servicing the NDA account in 2020.
September 20, 2019, I contacted Pat Bourne asking him what was going on with Aon. Pat said that he was brought into Aon to develop the Omaha office. He told Aon of his plans to get rid of some toxic employees and bring in others who he knew to be talented, one of those being Jerome. After he hired Jerome, Aon told him that he could not hire anyone else. Aon had made the decision to develop other markets, Omaha not being one of them, so when Steve Clausen said that they were having a hard time finding people for Omaha, it was not true. Pat said that Jerome and Jody were already overworked during 2019. Because Pat realized Aon’s view of the Omaha office, he left for Medica. Jerome left shortly thereafter.
Pat suggested contacting Jim Garbina with Harry A. Koch. The NDA Board of Trustees interviewed Harry A. Koch last fall as a part of this process.
September 23, 2019 – spoke with Jim Garbina, the head of Koch Employee Benefits Division. Koch is a big UHC agent, so transferring responsibilities will not be a problem.
Jim Garbina spoke to the NDA Board via conference call on September 27th. The NDA asked Jim to speak to UHC on our behalf to see what is going on and if Koch could be our agent going forward.
Hopefully, we will know more soon as we know our members are trying to line up health insurance going into 2020.
June 25, 2019
The learning curve with launching an association health plan continues, but a recent lesson can be summed up in two words— realistic expectations. With the news that NDA members would at long last have access to a “group health insurance plan,”
We have learned a great deal in the process by observing another professional association health plan that launched a year before the NDA’s plan. When offices were starting to receive their quotes, it sounded like nobody was receiving a quote that was any good. So we asked Aon to review the quotes coming from United Healthcare and compare them to the other association that we were learning from.
The July/ August/Sept 2018 newsletter explained the rating system as it was explained to the NDA Board by the insurance agents being interviewed. A baseline rate would be established looking at the group as a whole, then each office would be rated individually off of the base rate. The example used in the July/August/ Sept 2018 newsletter used a bucket system to rate your office. The Comparison Chart below is a comparison chart that the Alliance Board reviewed with Aon and UHC a few weeks ago.
Aon selected a plan option (NDA Option 3) that had similar benefits to the other association plan. The Low, Mid and High columns are the lowest rate available, the Base Rate and the highest rate of the other professional association we were comparing to. In other words, no individual in the other association would receive a quote for an individual less than $441.01 per month.
In comparing quotes received by our offices, one-third were receiving quotes less than the lowest available quote of the other association. The next third were receiving quotes higher than the lowest rate of the other association, but less than their base rate. The final third were receiving quotes that were not competitive. The trend of the bottom third, noncompetitive quotes were smaller offices, health issues, or both. I fell into that bottom third quote because I was the only person in the NDA office getting a quote and I am over 60 (thankfully, no serious health issues). Aon informed me that the offices in the bottom third of Alliance quotes will also receive an ACA quote from UHC. In one instance I know that an NDA office Alliance quote of over $600/ month, dropped to the low $400s/ month with an ACA plan quote.
As our member offices contemplate participation in the Alliance UHC plan, Aon and UHC are committed to make this a successful member benefit.
May 23, 2019
Dental offices of all sizes face significant challenges in relation to the affordability of health insurance. The NDA is proud to offer insurance options for its members, which lead to the creation of the NDA Health Insurance Alliance.
The Alliance consists of multiple employers, with NDA membership, pooling together to obtain health insurance coverage on terms similar to those currently available only to large employers. Here are some of the advantages:
- Coverage: By pooling together, employers are better positioned to obtain more affordable healthinsurance coverage due to economies of scale, managing savings, and spreading risk.
- Flexibility: Each employer in the Alliance has the option of selecting the type of health plan or plans that works best for its employees (high deductible plan vs. lower deductible plan, etc.).
- A Stable Community: The Alliance's goal is to create and to encourage a stable community of employers participating in the Alliance for the long term. When a group has a stable environment, annual rate fluctuations are less likely and less dramatic from year to year.
- Available to Family Members: In addition to staff, employers participating in the Alliance may offer family and dependent coverage to their employees
The Alliance Board met with United Healthcare and Aon last night to review the progress to date. Since the launch of our offering on April 1, 2019, we have seen dramatic interest in the insurance. We realize time and effort is needed to provide the required information for rates, THANK YOU for taking the time to do this. As a result of your efforts we've been able to do analysis and the results have been consistent with initial expectations.
The Alliance Board reviewed quotes from 60 NDA offices and compared those rates received by another large association with a different carrier, with a plan design very similar to the Alliance. The rates received by NDA offices are consistent with the other association plan and tended to stratify as shown below.
33% of offices may benefit
33% of offices may be neutral
33% of offices may be better with their current options
After an initial evaluation, the NDA Health Insurance Alliance is falling within the above expectations, meaning the NDA Health Insurance offering will benefit some offices, but not all in the short term. For those offices falling in the bottom 30%, Aon will also send a quote from UHC with a plan based on the Affordable Care Act.
While the NDA Health Insurance continues to grow, if you have not realized the potential benefit of the offering, it is important to understand circumstances can change within your office and as they do we encourage you to keep reviewing your option of joining the NDA Health Insurance Alliance. There is no limit on; the number or frequency of times you can submit your information for review throughout the year.
The goal of the NDA Health Insurance Alliance has been and remains to provide another option for your office that has not been available to you before. Through the pooling of resources of the multiple dental offices; steady, consistent growth will ensure the long term viability of the NDA Health Insurance offering.
As the NDA Health Insurance continues to grow, if you have not realized the potential benefit of the offering, it is important to understand circumstances can change within your office and as they do please keep reviewing your option of joining the NDA Health Insurance Alliance.
The NDA Health Insurance Alliance offering remains a valuable offering and we are committed to its long term success.
We encourage you to reach out to Jody Gilcrist(email@example.com) or Jason Rothermund(firstname.lastname@example.org) to ask questions or learn more.
Februrary 20, 2019
The Alliance Board met with UHC and Aon to approve the NDAA Plan Options available to NDA offices.
For offices that had already submitted a Health Insurance Survey, Aon has emailed those offices directly to obtain employee email address in order to fill out more information through EaseCentral, the online portal to communicate Office information with Aon.
If your office did not fill out a Health Insurance Survey previously, please email either of these individuals - Jody Gilcrist (email@example.com) or Jason Rothermund (firstname.lastname@example.org) - with the following information:
1. Dental Office Name
2. Group level contact (ie. HR/Payroll person)
3. Complete the Dental Office Employee Email Address spreadsheet that includes all employees at the office with their email address.
On December 20, 2018, the first meeting of the NDA Health Insurance Alliance,
was held with Michelle Sitorius, attorney for the Alliance, NDA Executive Director David O'Doherty and Board members Drs. Brad Krivohlavek, Chris Foix
, Shay McGowen, Sami Webb and Steve Wirth
. The Board elected the following officers: Drs. Krivohlavek (President), Chris Foix (Vice President) and Steve Wirth (Secretary/Treasurer). Only NDA members who will be purchasing insurance through the Alliance are eligible to be Board members. The Board then approved filing a Form M-1 with the Department of Labor. In January, the Board will be reviewing plan designs with United Healthcare to be introduced to NDA offices later in January.
If your office has not already submitted a Health Insurance Survey and you are interested in receiving information on health insurance through the Alliance, you may contact Michaela Valentin directly at Aon.
On November 16, 2018, members of the NDA Board of Trustees pictured below and Pat Bourne and Michaela Valentin, team leaders for Aon Risk Solutions interviewed representatives of United HealthCare and Aetna. Blue Cross & Blue Shield intially indicated a desire to particpate, but later declined. After an afternoon of interviews, the Board selected United Healthcare as the insurance carrier for the NDA Health Plan. Aon and UHC will meet to finalize a number of plan options for the Board to select - six options in total for NDA members and employees to choose from.
If Your Office Hasn't Done So, Fill Out the Health Insurance Survey If you need the Survey in Numbers Format, please let me know.
The image below is an example of responses of a three person office to the Insurance Survey. Fill in information for all employees and their dependants, including dentist owners and associates. Responding to this survey does not obligate you or your employees to purchase insurance from the Alliance.
Please include spouse/dependent information for everyone in the office except those Waiving coverage. Part-time employees working a minimum 17.5 hours per week may also be included.
Save the file, and email the completed spreadsheet to email@example.com
Will This Be Ready by January 1, 2019
No. However, the current schedule is as follows:
Statewide education campaign Jan - March, 2019
Enrollment period - March 2019
Effective date - April 2019
What Do I Do For the Beginning of 2019?
Continue with the coveage that you currently have. Once the NDA Plan is effective, you will be able to move to the new plan. What about my deductibles?
UHC will allow you to carry over your deductibles to your new plan!
Participation and Eligibility
Once a Base Rate is established for the group and the individual dental office wishing to participate has been rated, that office must satisfy the Participation and Eligibility rules set by the insurance company.
The video produced by the Michigan Dental Association for their own plan, explains how this works.