PEBB members discuss dental plan changes to encourage preventive services

Members of the Washington State Health Care Authority’s Public Employees Benefits Board (PEBB) discussed proposals for updates to its uniform dental plan during a meeting Thursday.

 

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PEBB purchases and coordinates insurance benefits for eligible public employees and retirees, and serves more than 300,000 members. Employees and Retirees Benefits Division Senior Account Manager Ellen Wolfhagen discussed dental plan proposals during the meeting. 

PEBB’s current dental plan pays a maximum payable amount–payable by DDWA/Delta Dental–of $1,750 for Class I, II, and III dental benefits each benefit period. The member must pay any amount over that. Class I services are preventive.

“While preventive services are covered at 100 percent, they currently count toward the plan maximum,” Wolfhagen said. “This could have a big impact if one were to use more expensive services earlier in the year, and then have preventive services.”

Preventive services include visits for cleanings, exams, X-rays, periodontal maintenance, and fluoride applications.

“The benefit change we’re talking about is removing ‘preventive services’ from the annual plan maximum to create incentive for using preventive services,” Wolfhagen said.

Wolfhagen also discussed a proposal for eliminating deductibles for children. The current plan’s deductibles do not apply to preventive services. 

“The change we’re looking at is to eliminate the $50 deductible for children up to the age of 15,” Wolfhagen said.

Board member Scott Nicholson said he supported the plan for eliminating deductibles for children, noting that parents sometimes have to make tough decisions when it comes to what they can fit into their budgets, and health care should be a priority.

“With inflation, families are struggling with hard decisions,” Nicholson said.

With several other proposed changes, subscribers would see their monthly dues increase by between $5-7 per month. But board member Elyette Weinstein said families would save money in the long run by getting preventive work done.

“It prevents them from having to get [more costly] work done down the road, like crowns,” Weinstein said. “You’re teaching children to have good patterns of getting good dental care, and it will save money down the road.”

Board members will continue to discuss dental plan proposals in future meetings, and will eventually vote on them.