RSSWarwick Council Postpones Decision on Dental Insurance
The debate is always emotional when the City Council considers health (or dental) insurance.
Monday night’s meeting was no different. But it was dentists, not city employees, who showed up to make their voices heard with respect to the city council’s decision to choose a plan administrator for its self-funded plan.
As it does with health insurance, the city self-funds its dental plan. That means it assumes the risk and pays claims directly – undeniably a cost-saver for an operation the size of the city.
The two dentists at the meeting, as well as the four or five who contacted City Hall prior to the meeting, were all concerned with “changes at Delta Dental” pertaining to payments.
Blue Cross Blue Shield of Rhode Island bid an administrative rate of $2.40 per month per subscriber. Delta Dental, through the West Bay Health Collaborative (WBHC), bid $4.13 per month per subscriber.
The city spends roughly $900,000 per year on dental insurance.
The city council, however, made no decision on the issue. Instead, the Council asked Blue Cross and Delta Dental for their claims information, in order to conduct more comprehensive a cost analysis.
Officials from the WBHC and Delta Dental argued that their bid included a rebate that would have let the city pay less than the actual rate the company bid. But City Personnel Director Oscar Shelton said that there was no guarantee of that in the bid, and, therefore, he felt uncomfortable about recommending it.
“There was absolutely no guarantee in writing,” said Shelton.
In using an outside company to administrate the claims, the city is also using that company’s discounts with its dental network. The WBHC argued Delta Dental’s discounts would save the city significant amounts of money.
“You need to remember that the administrative fee represents just ten-percent of the cost. It’s the claims that make up ninety percent of the cost of dental insurance,” said Robert Dooley, the former finance director from the Warwick School Department who now leads the WBHC.
Ray English, a Warwick Oral Surgeon, said that he had trouble sorting out claims and being reimbursed by Dental Dental. The frustration mounted, which led him to refuse to do business with the company.
“I left their network because I was extremely concerned with some of the changes that have gone on at Delta Dental. Basically, the difficulty came from the difficulty with claims, rejection of claims that should have been approved,” said English.
English’s arguments seemed to suggest that Delta Dental does, in fact, pay less money in claims due to denying claims and reimbursing dentists at a lower rate than Blue Cross.
“You get what you pay for,” said English.
Diane T. Monti-Marokowski, the Executive Director of Blue Cross Dental said that Delta Dental would “deny claims.”
She also argued that denying claims make dental care more costly in the long run.
“Denying appropriate treatment only drives up the cost later on,” said Monti-Marokowski.
Both dentists pointed out that Delta is under investigation from the state Department of Business regulations after several dentists complained about denied claims.
Neither, however, brought up the fact that in December of 2007, Blue Cross entered into an agreement with the U.S. Attorney’s Office to pay $20 million to the Rhode Island Foundation to avoid possible corruption charges for influence peddling in the state legislature. The company was also forced to acknowledge wrongdoing of four company executives.
Officials from Delta argued back that they wouldn’t deny claims, but would manage them more effectively.
The decision to choose a plan administrator for health insurance featured a similar debate, but was more emotional for city employees. Shelton said that city employees are nowhere near as concerned with which company administrates their dental insurance policies as are about health insurance in general.
Hundreds of city employees packed into council chambers at meetings where the city was slated to decide the insurance plan administrator over the last few years.
There were few, if any, concerned city employees at Monday night’s meeting.
Read more: Warwick Beacon – Council postpones decision on dental insurance