Expanded benefit designs include introduction of four new dental PPO plans
Citing growing evidence that pregnant women with gum disease are more likely to deliver pre-term babies, Blue Shield of California is introducing an enhanced small group dental benefit for pregnant women. Effective April 1, 2006, the enhanced benefit will enable members to receive additional periodontal treatments and maintenance during pregnancy. The benefit also will cover additional cleaning for those not affected by periodontal disease to address the potential risk of pregnancy gingivitis.
A study published in the July 2001 Journal of the American Dental Association showed that pregnant women with chronic gum disease during the second trimester may be up to seven times more likely to give birth prematurely. A report by the Journal of Periodontology found as much as an 84% reduction of premature births in women who were less than 35 weeks pregnant and who received periodontal scaling and root planning.
“This enhanced dental benefit for pregnant women demonstrates Blue Shield’s commitment to the health of its members,” said Bob Clifton, vice president of Blue Shield’s Ancillary Group. “By encouraging women to receive oral exams and, if necessary, treatment for gum disease during the early stages of pregnancy, we may be helping them to avoid further complications and costs as their pregnancies progress.”
In addition to the expanded benefit coverage for pregnant members, Blue Shield is expanding dental coverage options with four new dental PPO plans for small groups. The new plans give employers more options including two plans with lower-rates and two with richer coverage.
The two new lower-rate plans are:
· Smile Value 50/1500/No Ortho/MAC ($50 deductible per person, $1,500 annual maximum, no orthodontic coverage, and maximum allowable covered for out-of-network services) and,
· Smile Plus Gold 50/1500/Ortho/U85 ($50 deductible per person, $1,500 annual maximum, orthodontic coverage, and 85th percentile of usual, customary and reasonable [UCR] for out-of-network services).
The two new plans with richer coverage are:
· Smile Deluxe 2000 50/2000/No Ortho/MAC ($50 deductible per person, $2,000 annual maximum, no orthodontic coverage, and maximum allowable covered for out-of-network services) and,
· Smile Deluxe Plus 2000 50/2000/Ortho/MAC ($50 deductible per person, $1,500 annual maximum, orthodontic coverage, and 85th percentile of UCR for out-of-network services).
“Employer-based dental coverage consistently tops the list of desired benefits on the part of employees,” said Clifton. “Our new dental plans are designed to broaden the array of choices for small group employers and their employees.”