Aflac Dental and Vision Insurance Process Guide and Timeline

Aflac Dental and Vision Insurance

Process Guide and Timeline

Sales Strategy

Prospecting

enrollment Pre-

Product Overview

Quoting/

Proposal

Account Set-up

Enrollment

Administration/

Servicing

Commission

Please use the duck icon on each page to

navigate back to the home page.

Enrollment Processing Timeline

1-2 days

The system calculates whether minimum participation was met.

Once Open Enrollment ends, Everwell feeds the file with all enrollment information to Aflac Tampa.

An email is sent to the account and agent.

• If more than one plan design is offered, each plan must meet participation in order to be established. Only the plans that meet participation will be approved.

Aflac Tampa begins processing the case and account set-up activities start.

• The file goes to Aldera to set up the case and enter the members .

• ID cards are created and sent via USPS - also can be accessed by certificate holder on the portal.

• Welcome packets are created and emailed to the account with cc to agent. All email addresses come from the master app and include:

̶ Welcome letter

̶ Policy

̶ Census of who is covered

̶ A link to portal where temporary ID cards can be accessed if needed 4-7 days

We expect to see numbers visible in RPM 7 days from when the Welcome Packet is sent to the group.

4-7 days

INVOICES are generated on the 22

of the month and sent via USPS on the 23

. Bills can be reviewed in the portal at this time.

COMMISSION PAYMENTS Commissions are paid on the 15

of the month after the premium is received. See examples below:

Scenario 1

• The May invoice is sent on April 23

.

• Account pays the invoice on April 28

.

• Commissions will be paid on May 15

. Scenario 2

• The May invoice is sent on April 23

.

• Account pays the invoice on May 2

.

• Commission will be paid on June 15

. Note: Commission payments will be mailed on the 15

or the next business day if the 15

falls on the weekend or a holiday.

1 day 1 day

QUOTING

Be sure to update the total employee count and benefit-eligible employee count prior to running a quote or proposal. If updates were made, be sure to do a group refresh.

ACCOUNT SET-UP

Once the master application

information is completed, an

email will be sent to the

account administrator. The

administrator should logon to

the system and approve the

application. Once approved the

enrollment can begin during

the selected open enrollment

dates.

Sales Strategy

Existing Accounts - Drive Penetration

We believe dental and/or vision can help deepen our existing Afac account penetration rates. Again, leverage the dental and/

or vision offering to obtain enrollment conditions, which give you the opportunity to sell more Afac voluntary benefts.

Add dental and/or vision to existing cases to provide solutions for accounts and drive persistency. The dental plan’s Deductible that Decreases over Time and Maximum Carryover Beneft make it diffcult for competitors to takeover the business.

New Accounts

There are specifc beneft offerings that employees have come to expect from their employer, and they can be the deciding factor in whether they take one job over another equivalent option. This often includes major medical, dental coverage, and life insurance. Use the dental and/or vision products to start beneft conversations with new employers and leverage them for one-on-one enrollment conditions.

• As yourself this question ... “what is the defnition of insurance?”

• Then ask ... “does dental ft this defnition?”

• That is WHY, dental benefts are among the top three employee benefts that employers consider to add in the near future if they currently don’t offer any insurance benefts.

• Afac has another plan that also encourages usage, so don’t overlook Vision.

Larger accounts

Afac has the ability to provide custom quotes in the 100+ employee case size. This gives us the ability to match almost any competitor’s plan designs and rates.

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Trends in Dental Insurance: Employer, Employee, and Carrier Perspectives, LIMRA 2019.

Prospecting

3-49 employee accounts

Accounts of this size may not offer dental insurance, so they could gain an advantage in the talent marketplace by providing a valued beneft package including Afac dental coverage alongside other Afac benefts to enhance retention and employee engagement.

50-99 employee accounts

Accounts of this size are more likely to provide dental insurance. However, decision-makers and their brokers may be interested in replacing their less compelling network dental product, or supplementing their existing with our Afac voluntary dental coverage.

Given the strength of the Afac brand with buyers, the new dental plans can offer takeover opportunities for current, new or previously lost accounts.

As always, consider the industry and the account’s demographics. Are there primarily parents and families among the

employees? How could you position dental coverage to appeal to an account’s specifc employee population to solve for problems they are likely dealing with? An example would be orthodontic options for account’s that have employees with young families.

Existing account opportunities

• Engage accounts approaching open enrollment in the next 60 and 90 days. Make sure you are familiar with the dental plans they currently offer their employees and include one of Afac’s Dental options in your re-enrollment strategy.

• Leverage the email and letter templates available in CCLM to inform your accounts about the new Dental and Vision plan offerings.

• Approach accounts not currently offering any form of dental insurance to employees, or accounts that have low employee participation (< 30%) in their dental plan due to high premiums or insuffcient coverage.

• Offer Afac Dental to engage accounts that have been inactive for the past 13-24 months. Afac Dental should be included in your approach strategy and in your customized OCP (other centered positioning).

• Focus on accounts without existing supplemental dental or vision. Afac dental and vision cannot be sold in accounts with existing supplemental dental and/or vision on the invoice.

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Pre-Enrollment

Effective May 21, 2021, the eligible employee count for dental/vision can be updated in Everwell. See screen shot below. Prior to this date, you must update the information via a new M0138 or the account may email or send a letter to [email protected] with the appropriate employee counts.

• Link to Decision Tree

• Link to Account Checklist

• Link to Dental Product Education Guide.

Open Enrollment Dates

Setting the correct enrollment end date for any plan year with Afac Dental and Vision products is critical to eliminating enrollment issues on the back-end.

• Everwell will automatically send groups to Afac Tampa for fnal processing once the enrollment end date is reached.  If applications are taken after the enrollment end date, they do not get passed to Afac Tampa until the initial enrollment has processed and you may experience issues like members without coverage or missed participation.   

• Enrollment date must end 7 days prior to effective date (best practice to end by 15th).

• Enrollments must be completed by the open enrollment end date.

• If there is a need to change the open enrollment dates AFTER the master application has been signed,

- You will be required to submit a ticket to the Everwell Support team and request the dates to be cleared from the system.

- The entire enrollment process will then need to be restarted with a new master application.

• If there is a need to extend the open enrollment period,

- This can be done IF the open enrollment end date has not occurred. You can change the open enrollment date in Everwell.

- If the open enrollment end date has passed, you can not submit additional applications unless they are for new employees or an employee with a Qualifed Life Event.

• If you have already submitted a master application and need to change the coverage effective dates,

- You will be required to submit a ticket to the Everwell Support team and request the dates to be cleared from the system.

- The entire enrollment process will then need to be restarted with a new master application.

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Product Overview

Click here to access the Dental Product Reference Guide.

Click here to access the Vision Product Reference Guide.

Review the Training presentation slides 9 -16 for information on the following product highlights:

• Afac Supplemental Dental vs. Afac Dental.

• Learn about the differences between MAC plans and PPO plans and when to offer each plan.

• The advantages of the Afac Dental plan.

Quoting and Proposals

Click here for information on Quoting and Proposals.

Click here for information on how to request a quote for accounts with 100+ employees.

Click here for a quick tutorial on how to Create a Proposal.

Click here for information on how to use Quick Quote.

Need additional assistance with quoting? Click here to reference the Producer Decision Tree.

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Account Set- Up

Link to Dental Product Education Guide

Master Application

• Submit the master application/carrier form to group administrator.

- The group administrator must approve the document prior to enrollment.

- Click here for a video on Completing the Master Application.

• Once the master application information is completed, an email will be sent to the account administrator. The

administrator should log-on to the system and approve the application. Once approved the enrollment can begin during the selected open enrollment dates.

• Billing method will default to a paper invoice.

- To request ACH billing the account will need to email [email protected] to request the ACH

authorization form and to obtain access to the portal.

Enrollment

Effective May 21, 2021, the eligible employee count for dental/vision can be updated in Everwell. See screen shot below. Prior to this date, you must update the information via a new M0138 or the account may email or send a letter to [email protected] with the appropriate employee counts.

Link to Dental Product Education Guide Insert link to Account Checklist

Link to Producer Decision Tree

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Participation percentages must be met by the end of enrollment. Applications taken after the end of the open enrollment date will NOT be sent to Afac Tampa.

• Applications will be transmitted after the open enrollment end date.

• Applications/enrollments will be moved from the “unsent” to “sent” section in Everwell once the minimum participation is confrmed and the group setup is complete at Afac Tampa. This typically takes 48-72 hours after the open enrollment end date.

TO:

• Enrollment date must end 7 days prior to effective date (best practice to end by 15th).

• Currently, if the enrollment and application processing is not completed prior to the invoice generation date (22nd of the month) and invoice will not be generated until the following month.

• Processing will take up to 7 days from this point.

• Application will not show in PBI.

• If participation is not met, you will be notifed via email and you must notify the account and employees.

RPM

• Business should appear in RPM 7 days after the welcome packet is sent to the employer. The agent is copied on the

welcome packet email. Afac Tampa will ensure business is credited in the appropriate quarter, regardless of processing

date.

Business Processing Timeline Example

1. Open Enrollment ends. File is sent to Afac Tampa = 1 day

2. Minimum Participation met or unmet confrmed by Afac Tampa = 24 - 48 hours

If minimum participation is not met, email sent to the account administrator and associate.

3. Account set-up and business issued = 7 days Welcome packet/ID cards sent to the account.

4. Business appears in RPM = 7 days after the welcome packet/ID cards are sent.

Account requiring an exception will require additional time to process.

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Administration/Service

Link to Dental Product Education Guide Link to Producer Decision Tree

• If participation isn’t met, associate and account administrator will receive an email from Everwell notifying them of the plan option that did not meet participation. The agent/account administrator and must notify the employees coverage will not be issued.

• Welcome packets and ID cards are mailed when the business is processed (7 days from the open enrollment end date).

• Deduction summary can be pulled from Everwell or Producer Portal.

• Associate and account must request access to the portal through [email protected] for frst time portal access.

• Associates and account must request access through [email protected] for frst-time portal access.

• For business written on NGL paper (pilot states), associates will see all groups they are associated with under their writing number. If the associate uses a different Afac writing number for each group, a separate log-in for each writing number will be needed.

• For business written on Afac paper, associates will need separate log-in access setup for each group they enroll. This admin access can be granted under the group if the associate wants access to invoices, ID cards, etc. Associates will not need admin access if only looking for commission information. This access is granted under the main writing number.

• Overpayments made on the invoice will be applied as a credit to the next invoice. No account refunds.

• Name, address, cancellations and reinstatements should be completed in Everwell. Changes cannot be made on the invoice and must be done in Everwell.

• Billing

- Invoices generate on the 22nd of each month.

- If the business is not processed prior to the 22nd of the month, the account will not receive an invoice for the frst month, but will be double billed on the next invoice.

- Under 100 will be sent a bill (email [email protected] to request ACH authorization form).

- Account must request access through [email protected]

Commissions

• Commissions are found in portal (as earned and levelized).

• Commissions for Afac Dental will be paid as earned and levelized.

• Currently commission payments for the Afac products will be mailed to the associate on a monthly basis. We will advise when direct deposit is available.

• Commission payments for NGL products can be paid monthly by ACH if this option was selected when you completed the appointment paperwork. If ACH was not selected, commissions will be paid on a quarterly basis by check.

• Commissions are paid the 15th of the month after the premium is received. See example below.

- Scenario 1

› The May invoice is generated on April 22nd.

› Account pays the invoice on April 28th.

› Commissions will be paid on May 15th.

- Scenario 2

› The May invoice is generated on April 22nd.

› Account pays the invoice on May 2nd.

› Commission will be paid on June 15th.

- Commission payment will be mailed on 5/15 or next business day if the 15th is on a weekend or holiday.

- Commission statements for NGL sales and Afac sales are available in the portal.

› If you have already registered for portal access, visit www.AfacDental.com.

› If you are accessing for the frst time, you must email [email protected]. Log-in credentials cannot be given via the phone.

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Confdential – For Informational and Training Purposes Only. These materials contain proprietary information and material that is owned by Afac and/or its licensors, and is protected by applicable intellectual property and other laws, including but not limited to copyright. By accessing these materials, you agree that you will not use such proprietary information or materials in any way whatsoever except for informative and training purposes only. You further agree not to modify, loan, sell, distribute, or create derivative works based on these materials. Any use not specifcally permitted herein shall be considered to be a material breach of your Agent’s contract with Afac and is strictly prohibited. Any use not specifcally permitted herein is strictly prohibited and may subject you to civil and criminal penalties.

Afac dental and vision insurance coverage from the 2020 pilot launch is underwritten by National Guardian Life Insurance Company (NGL). National Guardian Life Insurance Company is not a member of the Afac family of insurers. National Guardian Life Insurance Company is not affliated with The Guardian Life Insurance Company of America a/k/a The Guardian or Guardian Life. Afac dental and vision products may not be available in all states.

National Guardian Life Insurance Company | Madison, WI.

For all states that have approved the Afac dental and vision insurance products, coverage will be underwritten by Afac. In New York, coverage will be underwritten by Afac New York.

Afac WWHQ | 1932 Wynnton Road | Columbus, GA 31999.

Please see coverage documentation applicable to your situs state for further details.

Notice to Consumer: This is a limited beneft plan and provides dental or vision benefts only. Afac’s contracts of insurance, including Afac’s network dental and vision plans, provide limited-scope and/or supplemental benefts only and do not constitute comprehensive health insurance coverage. Afac’s contracts of insurance do not satisfy the requirement of minimum essential coverage under the Patient Protection and Affordable Care Act (ACA) and are not designed to meet any of the essential health beneft requirements mandated by the ACA or federal law, including pediatric oral or vision care services. Afac’s contracts of insurance are not an alternative to, or a substitute for, comprehensive health insurance coverage and should only be used to supplement comprehensive health insurance coverage.

AGC2100717 EXP 5/22