Excellus BlueCross BlueShield. Dental Business Program Guide An Experienced, Committed Partner

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1 Excellus BlueCross BlueShield Dental Business Program Guide 2012 An Experienced, Committed Partner

2 Excellus BCBS Six Regions Watertown Potsdam St. Lawrence North Country Malone Plattsburgh Franklin Clinton Jefferson Watertown Essex Western Niagara Orleans Buffalo Batavia Genesee Erie Wyoming Chautauqua Cattaraugus Allegany Jamestown Genesee Central Lewis Hamilton Oswego Rome Oneida Rochester Utica Wayne Syracuse Monroe Herkimer Onondaga Ontario Auburn Seneca Madison Cayuga Livingston Yates Otsego Tompkins Cortland Chenango Oneonta Ithaca Hornell Schuyler Steuben Chemung Tioga Binghamton Delaware Elmira Broome Southern Tier Tri-Cities Utica-Rome Fulton Amsterdam Montgomery Albany Eastern Syracuse region Southern Tier region Rochester region Utica region Western region N/A 2

3 Strong Network of Participating Dentists Established for over 25 years 85% of local General Dentists and Specialists Over 90% of services performed by network dentists Negotiated fees typically 15-30% below the average charges No balance billing or submission of paperwork Low turnover rate / Stable Fee Increases 3

4 General Underwriting Guidelines Funding Arrangements: Pooled Experience (2-50 eligibles) Experience Rated (51 + eligibles) Self Funded (100 + contracts) 4

5 Dental Underwriting Guidelines Pooled Experience 2 + enrolled for free-standing dental Groups < 10 contracts 50% max on Class III Groups must have Min. 10 contracts to qualify for orthodontics 2-Tier and 4-Tier options available 5

6 Dental Underwriting Guidelines Contributory Employer Contribution 25% or greater of the single premium Participation Percent 50% minimum and a minimum of 5 enrolled Dual Offering 51 or more eligible. Plans must have different designs in order to add ortho benefit to one Waiting Periods None 6

7 Dental Underwriting Guidelines Voluntary Participation Percent 50% min. and a min. 5 enrolled Dual Offering Waiting Period 51 or more eligible. Plans must have different designs in order to add ortho benefit to one 12 months for Class IIA, III, IV 7

8 Rochester Region Smile Saver Plans Largest in force block of business Remains available for all existing in force groups No enhancements will be made to the product Not available for voluntary programs 8

9 Rochester Dental Blue Options Product platform for future enhancements Preferred product for all new sales Passive and Incentive PPO Designs Low cost options 9

10 Smile Saver to Dental Blue Options Pooled Experience Smile Saver rates increasing approximately 5% Dental Blue Options rates increasing 1-2% Dental Blue Options rates are 20 + % lower Sell over available to groups < 100 contracts Reduced underwriting (GIF and signed rate sheets) Group to Group Transfer available (no apps required) Voluntary Smile Saver plans must move to voluntary Dental Blue Options (5% premium load) 10

11 Experience Rated Groups 2012 Changes Discounted Claims Experience Metlife and Guardian Must provide claims experience to include contracts and claims Must provide current Plan Design 11

12 Smile Saver vs. Dental Blue Options Class Comparison Class Smile Saver Dental Blue Options Class I Fluoride Treatments to age 19 Fluoride Treatments to age 16 Space Maintainers Anesthesia (IV Sedation for 3 rd Molars) Class II Periodontics Endodontics Class IIA Periodontics Endodontics Class III Space Maintainers Implants Class IV ½ of Ortho max paid in one year 12

13 2012 Pooled Experience Rate Comparison Product Design 2011 DBO Rates 2012 DBO Rates 2012 Smile Saver Rates 100,80,80,50,50 Single Family Single Family Single Family $50/$150 $28.64 $79.73 $29.17 $81.26 $42.80 $ $1000 Annual Max Contributory Contributory $750 Ortho Max 26/26 100,50,50,50,50 Single Family Single Family Single Family $25/$75 $23.84 $66.98 $24.29 $68.28 $35.58 $98.85 $1000 Annual Max Contributory $1000 Ortho Max 26/26 13

14 Excellus BCBS Dental Please contact your Account Consultant to schedule a time to discuss important program enhancements for 2012.