Created by dentists for dentists: because your family deserves complete protection and you deserve affordable rates.
The LDAHPT is a private, not-for-profit, self-funded, health benefit plan developed by the Louisiana Dental Association (LDA) exclusively to help member dentists and their staffs battle the increasing cost of providing health care benefits for themselves and their families. The LDAHPT utilizes the buying power of its association members as a combined group to provide healthcare benefits at competitive rates for qualifying members through a Multiple Employer Welfare Arrangement (MEWA).
The LDAHPT is designed to offer significant savings to most member dentists. It is unique and only available to LDA members and their staffs. Because the LDAHPT is a self-insured plan, it has many benefits, including the ability to design plan and deductible options, bring group rates to even solo practitioners, choose networks and features, and keep costs low by avoiding the state insurance premium tax and many of the ACA’s mandated taxes.
Healthcare Highways (HCH) – Third Party Administrator
Brown & Brown Association Services Professionals – Marketing Agency
Cottingham & Butler – Plan Supervisor
Lewis & Ellis – Actuary
IronShore, a division of Liberty Mutual – Reinsurer (A. M Best rating A+ Superior)
Because the LDAHPT is a self-insured plan, the benefits are not guaranteed by a licensed insurer and are not covered by the Louisiana Life and Health Guaranty Association. To mitigate this risk, the LDAHPT purchased a stop-loss insurance policy to protect the LDAHPT assets against losses above a certain threshold. But, in the event that the multiple employer self-insured health plan (or the stop-loss insurer) is unable to pay the plan’s obligations, the LDA would have to cover the unpaid obligations. And, in the highly unlikely event the aforementioned entities collectively could not cover the plan’s liability, the employers participating in the plan would be required to contribute the funds necessary to meet any unpaid obligations.
Group health plans – like the LDAHPT – qualify as a business expense for the employer. And, employees may pay with pre-tax dollars through a payroll deduction. Best of all, since group plans typically have lower premium rates than individual plans there are likely to be substantial premium savings for many members.
LDA member dentists that are business owners and their full-time staff members are eligible to apply for benefits. Employers may determine how many hours, between 24 and 40 hours per week, employees must work to be eligible for the plan.
All eligible, full-time employees must be offered the opportunity to participate, but they may decline benefits. The employer is not required to contribute to employee premiums.
Minimum participation is 50% of eligible employees within a dental office. All eligible employees waiving coverage because they are covered through their spouse, a parent or an individual policy will be counted as a “participant” for determining the participation percentage.
The LDAHPT offers 6 benefit plans with options for traditional copay plans or High Deductible Health Plans (HDHP) that qualify for the tax advantages of a Health Savings Account.
Medical underwriting will be conducted to determine actual rates.
LDAH Group enrollment is available throughout the year with effective dates generally being the first of the month following the date of application. Employees that do not choose to participate must wait until open enrollment to apply for benefits to be effective January 1. Alternatively, if you have a qualifying event, such as loss of your current insurance coverage, you may enroll within 60 days of the date of event.
A qualifying event is a life-change that makes you eligible within 60 days of the event to change your health insurance coverage outside the annual enrollment period. Life changes might include a marriage, birth, adoption, death, divorce, loss of coverage due to reduction in work hours, loss of job, relocation, or loss of student insurance or Medicaid.
The LDAHPT plans have calendar year deductibles. Therefore, if enrolling with an effective date other than January 1, the amount of deductible that has been met for the current year will not be credited to the new plan.
No, the rates are not guaranteed. The LDAHPT Board of Trustees (who are all LDA member dentists covered by the plan) works closely with the actuaries to monitor the plan. Though highly unlikely, the LDAHPT may adjust rates as needed during the calendar year.
The network providers are Verity and PHCS/MultiPlan. Please check their provider directories to obtain lists of current doctors and preferred hospitals.
Verity HealthNet: verityhealth.com/searchquery.asp
The first month’s premium will be paid via check. Subsequent payments must be paid via electronic fund transfer (bank draft) is required.
Yes. The LDAHPT covers the same set of Essential Health Benefits as mandated in the ACA with the exception of pediatric dentistry and vision.
Brown & Brown Association Services Professionals representatives are available via phone at 888-503-5547 and email at firstname.lastname@example.org to answer any questions you have about the health benefit plans and assist with completing the necessary forms.