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CLHIA Letter to Alberta Dental Association and College


Release Date: 06/30/2016
Staff Reference: Stephen Frank; Joan Weir

June 30, 2016

The Board of Directors
Alberta Dental Association and College
Suite 101, 8230 – 105 Street
Edmonton, AB T6E 5H9
reception@adaandc.com

To the Board of Directors,

The Canadian Life and Health Insurance Association established in 1894, is a voluntary association with member companies which account for 99 per cent of Canada's life and health insurance business. In Alberta, at the end of 2014, the life and health insurance industry provided more than 2.6 million Albertans with private dental plan coverage and made payments of about $1.2 billion on dental services, which represents approximately 90% of all reimbursed dental treatment in Alberta.

I am writing to you today on behalf of our industry members, regarding the information conveyed about dental insurance through your recent media campaign available at your website (www.dentalhealthalberta.ca) by clicking on ‘Ask Your Dentist’. Many of the statements made are important messages to consumers that CLHIA supports, such as encouraging dental plan members to discuss treatment options as well as encouraging consumers to understand the costs of treatment before proceeding. Having knowledgeable patients as well as informed dentists who can guide their patients through the predetermination and/or insurance claim process will serve to improve the dental visit experience for all.

That said, there are a number of statements that are not completely accurate and we would like to address them with you.

1) Most dental plans are, in fact, ‘insurance’ and to characterize them as ‘prepayment for services’ is not correct. Plan sponsors pay premiums appropriate to the extent of dental insurance coverage they wish to provide. While some patients may simply require routine preventative care, others may need additional funds for unforeseen treatment such as restorations or extractions. Dental insurance provides protection for expected and unexpected treatment. Dental insurance does not equate to a ‘prepaid amount per year’ and most employees do not fully utilize their available dental benefits unless there is a demonstrated need.


2) Our analysis of paid dental claims from Alberta indicates that dental providers charge widely varying fees for comparable services. Many dentists do consider ’100 per cent coverage’ from an insurer as payment in full for a service, while others may choose to charge patients more than the insurance payment regardless of the plan’s level of coverage. This is why it is important for all consumers in Alberta to inquire about costs and understand how much they will be charged prior to treatment. Any dental office can submit a predetermination to a dental plan carrier prior to treatment so plan members know in advance how much is covered by their plan before they take a seat in the dental chair.

3) Dental benefit plans are adjusted on an annual basis to keep pace with rising costs in Alberta. The dental plan administrators with members in Alberta proactively adjust the bases of payment for dental claims on an annual basis to keep pace with inflation and the price indexes, and inform plan members, plan sponsors and dental providers of increases to this bases of payment. Plan sponsors expect any increases (or decreases) to be connected to overall economic activity experienced in their region. Plan sponsors cannot support ongoing increases to their dental insurance premiums that outstrip their own business’s economic growth. This is why employers have not been increasing their benefit levels to keep pace with the significant year-over-year fee rate increases by dentists that has been seen over the last 10 years. It is important that your message to consumers be clear and accurate on all points. We request that you consider the points made in this letter.

Dental insurance plans play an important role in the health of Albertans, and in making regular dental care accessible to Albertans. As the Government of Alberta reviews dental fees and their impact upon access to care, we look forward to working with the Alberta Dental Association and College once Alberta Health Services issues their recommendations.

Should you have any questions, please do not hesitate to contact Joan Weir (jweir@clhia.ca, 416-359-2003).

Sincerely,

Original signed by Stephen Frank

Stephen Frank
Vice President, Policy Development and Health