June 2012 


ODS receives upgraded financial strength rating

ODS is proud to announce the A.M. Best financial strength rating (FSR) of ODS Health Plan, Inc. was upgraded to B++ (Good) from B+ (Good). A.M. Best also affirmed the FSR of B++ (Good) of Oregon Dental Service (ODS).  

 

The new A.M. Best rating reflects the company's continued commitment to improve our operating efficiencies and stabilization of ODS' risk-based capital levels.

 

"We are extremely pleased with the A.M. Best financial strength rating upgrade," said Dave Evans, senior vice president and CFO at ODS. "The rating upgrade is a testament to ODS investing in new technologies and implementing enhancements to improve our members' overall healthcare experience. Our customer-centric approach continues to play a central role in increasing our business efficiencies, maintaining ODS' strong reputation as a leader in service excellence, and delivering the best medical management and evidence-based healthcare the industry has to offer."

 

The A.M. Best upgrade recognizes ODS' improved operating results, capital growth, business diversification and strong market share. The company's favorable operating results have contributed to strengthening its risk-based capital. ODS has also developed a diverse revenue and earnings stream through its subsidiaries, and as Oregon's Delta Dental plan, continues to have a dominant share of the state's overall dental insurance market.

ASO partners to access digital SBCs for free 

 

To comply with new federal regulations aimed at making healthcare more understandable and user friendly, ODS will make digital summary of benefits and coverage (SBCs) available to our ASO partners free of charge.

 

Beginning Sept. 23, 2012, you and your employees will receive a digital copy of your SBCs via email from ODS Sales and Services so you can review details about what your individual plan covers and what it costs, including:

  • Overall deductibles
  • Deductibles for specific services
  • Copayment information by plan
  • Out-of-pocket limit on expenses
  • Services not covered by plan
  • And much more

 

Your employees will also be able to access their individual SBCs through their personal myODS account.

Dental visits: good for your health and your wallet 
 

Health research has shown a strong link between good oral health and overall health. In addition, regular dental checkups help cut down on expensive dental procedures, saving you money.

 

What is the purpose of preventive dental care?

 

Visiting the dentist regularly is a great way to catch problems before they become serious or painful. Taking good care of your teeth, gums and mouth helps prevent serious dental problems from developing.

 

Good oral health can have a positive affect on the rest of the body. Today, more than 100 diseases show early signs in the mouth and may first be detected by a dental exam.

 

Dental health affects some of the body's most essential functions, including speaking, chewing and swallowing. Untreated oral health conditions can lead to cardiovascular disease, respiratory illness, diabetes and pregnancy complications.

 

How can preventive care save you money?

 

Reports show that for every dollar spent on preventive care, members can save between $4 and $50 in restorative care*.

 

Receiving regular preventive care and dental checkups can help reduce the need for restorative dental care or emergency room visits in connection with oral health. By preventing the need for restorative care, members can save money.

 

For a list of ODS dental providers, visit www.odscompanies.com and click on Find Care.

 

* Ways to take a bite out of your dental bills University of Rochester Medical Center

ODS to issue Medical Loss Ratio compliance notice

To meet a new federal amendment that requires health insurers to inform policyholders and subscribers that they've met or exceeded the new healthcare reform's medical loss ratio (MLR) requirements, ODS will provide a notice to our group and individual market enrollees beginning July 1, 2012.    

 

Under the new MLR rules, health insurers must provide rebates to enrollees unless at least 85 percent of premium dollars in the large group market (80 percent in the small group and individual markets) are spent on clinical services and healthcare quality improvement. Insurers who met or exceeded the 2011 MLR standard, however, are not required to provide MLR rebates.

 

In December 2011, the Health and Human Services issued regulations implementing the MLR requirements, which ordered health insurers to report how they spend premium dollars. Since ODS met or exceeded the 2011 MLR standard, subscribers will not be receiving refunds from ODS.

Disclaimer 

Not all plans have access to all resources or tools referenced in this newsletter. Please refer to your Member Handbook, or call your ODS Sales and Account Services Representative for plan-specific information.

Volume 3, Issue 2      

In this issue:
A.M Best financial
Healthcare reform update
Preventive dental visits
Medical Loss Ratio compliance
Men's Health Month
June is Men's Health Month

"Recognizing and preventing men's health problems is not just a man's issue. Because of its impact on wives, mothers, daughters, and sisters, men's health is truly a family issue."

                  

- Congressman Bill Richardson

 

Join us in spreading the word about screenings and preventive care for men and boys. Speak to your provider today about what screenings and preventive care might be right for you or your family members.

 

To locate a physician, pharmacy or clinic near you, visit www.odscompanies.com. From there, click on Find Care.


Electronic EOB


Electronic Explanation of Benefits (EOBs) are now available. Members can sign up for eEOBs by logging into their myODS account at www.odscompanies.com. Help us spread the word and conserve resources. A downloadable PDF

is also available for your convenience.

myODS, your personal health resource

 

Don't forget to check out  myODS, your resource for health education, advice, tools and trusted answers to healthcare questions.

 

Visit ODS eDoc . You can email non-urgent health concerns to a doctor, pharmacist, dentist, psychologist, dietitian or fitness expert.

 

Contact a nurse 24/7 with health-related concerns at: 866-321-7580.


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