New CDA Member Benefit: Group Health Insurance

Kelsey CreehanFeatured News

Dental practices, like other businesses, are feeling the effects of increased healthcare costs and face the challenge of balancing these costs with healthcare coverage that supports employee satisfaction.

To address this issue, the CDA in partnership with COPIC Financial Service Group is proud to announce a collaboration with National General Benefits Solutions to offer CDA members, members’ staff and members’ families an affordable group health coverage program. Designed for small- to medium-sized businesses, this group health insurance plan offers a combination of cost savings and flexibility to fit your group’s needs.

Highlights of the National General Benefits Solutions Plan:

CDA Member Discount
CDA members receive a 10% discount on the group health coverage plans available.

Customizable Plan Designs
With National General, plan options are fully customizable depending on your needs. Flexible options to control costs include deductibles ranging from $500–$7,900, coinsurance options, Health Savings Account, COBRA administration, various copay options and more. All plans comply with the Affordable Care Act.

National Networks
With access to broad national networks like Aetna Signature Administrators PPO Network and Cigna PPO Network, you have choices to provide quality health benefits to your group’s members.

Level Funding
Level funding used to only be available to larger businesses. Now, small- and medium-sized businesses can experience the advantages without taking on added risk. It’s an easy way to stabilize your costs while providing quality healthcare benefits to your employees.  With level funding you’ll have one predictable monthly payment, and the opportunity to share in the surplus at the end of the year should claims run well.

A Product We Believe In
If you’ve been thinking about offering health insurance to your dental group, now is the time to explore your options with this new exclusive benefit to CDA members. The leadership team at CDA has been working hard responding to your requests for this kind of benefit. We are confident in our choice of products through National General with our trusted partner COPIC Financial Service Group.

For more information, contact John Kaufman, the CDA’s dedicated agent, for more information at 720-858-6299 or healthplan@cdaonline.org.

COPIC Financial Service Group is an independent insurance brokerage and consulting firm that works with physicians, dentists, members of the healthcare community and other professionals. They provide customized planning to make sure you are adequately insured, allowing your professional career and personal life to flourish. COPIC Financial Service Group is endorsed by the Colorado Dental Association as an administrator for its members’ business and personal insurance needs. 

CDA Group Health Insurance Overview

Here’s a more detailed look at the information you need to know before enrolling your practice in the National General health plan.

  • Plans are offered on a group basis with a minimum of two enrolled employees.
  • CDA members receive a 10% discount.
  • Participation requirements: 50% of all eligible employees after valid waivers must participate.
  • Practice contribution requirement: $100 per enrollee per month paid by practice to offset the employee cost. The practice can choose to contribute more per employee.
  • Work status: Employee eligibility hours can range from 20-40 hours per week to offer coverage.
  • There are multiple plan choices based on enrolling employee count:
    • 2 enrolling: 1 plan
    • 3-15 enrolling: 2 plans
    • 16+ enrolling: 3 plans
  • Underwriting process:
    • Rates are determined on a group-by-group basis.
    • All active eligible employees must complete an online health statement whether or not they plan on enrolling in the health plan.
  • Plans are “level funded,” meaning groups will have the opportunity to share in the surplus at the end of the year should their claims run well.
  • There are two nationwide networks to choose from: Aetna and Cigna.
  • There are two dedicated service teams: National General and COPIC Financial Service Group.

Frequently Asked Questions

Here are answers to some of the more commonly asked questions.

  1. What is the difference between a level funded plan and a traditional fully insured plan?
    With a traditional fully insured plan, the employer pays a fixed premium to the carrier based on the number of employees enrolled and their demographics. The premiums they pay are nonrefundable, regardless of whether you use the plan or not. With a level funded plan, you still have a fixed premium, but at the end of the year the practice could receive a rebate should claims (on a group basis) be less than your premiums.
  1. How can I see if my current doctor is in-network with this plan?
    Your health plan will be with either Aetna or Cigna. Visit these websites for a list of in-network providers:
  1. If I have a staff member with a pre-existing medical condition, can we still apply for coverage? And would our premium be affected by a staff member’s health status?
    Yes, any eligible employee can apply for health coverage, regardless of pre-existing conditions. Yes, premiums are determined by the overall health of the group.

  2. Does this plan cover my dependents?
    Yes, you have the option to enroll as employee only, employee plus spouse, employee plus children, or as a family.

  3. Can my staff be a part of this plan if I don’t participate as a dentist?
    Yes. 

  4. Do I have to be a practicing dentist to participate in the plan?
    Yes, retirees are not eligible for coverage.

  5. If I have already met some of my deductible this year, will it be credited toward the new plan?
    Yes, but some restrictions apply.

  6. How does this plan differ from the health insurance plan that the CDA offered 10+ years ago?
    In the previous plan, any CDA member could enroll on an individual basis. That structure created adverse selection, meaning that every time the premiums increased, the younger, healthier participants left the CDA plan and chose more economical health insurance plans. This ultimately made the CDA plan unsustainable and it was discontinued in November 2010.

    The 2019–2020 National General health plan is only offered at a group level; therefore, each group is underwritten separately, autonomous from another group.

If you have other questions or need more information, contact John Kaufman, the CDA’s dedicated agent, at 720-858-6299 or healthplan@cdaonline.org.