DDKS BYLAW AMENDMENTS
As a contracted dentists with Delta Dental of Kansas, you have the power to propose and vote on amendments to the DDKS Bylaws*. With the help of our legal counsel, United Dentists of Kansas gathers input from dentists across the state to propose amendments aimed at fostering CLARITY, FAIRNESS, TRANSPARENCY, FREEDOM OF CHOICE, and PARTNERSHIP in the complex and confusing dental insurance industry. We have provided a summary of the amendments that we are currently working on here.
*NOTE: DDKS recently amended their Articles of Incorporation to give themselves power to veto any dentist-proposed bylaw amendments that they do not support. The leaders of UDK are currently suing DDKS as we believe this change to the Articles is both invalid and illegal.
We are seeking to have a dentistry-specific definition for "medically-necessary" -- rather than the insurance definition, which is pretty much whatever they want.
We propose an amendment to recognize dentists may enter into individual contracts with patients where no benefit is paid.
We have proposed a provision to treat dentists fairly in the event that DDKS makes a mistake on a claim. If such an error occurs, we are proposing that DDKS cannot take money from another patient's claim in order to make up for their error. They must collect it from the patient.
Another amendment we have proposed in the spirit of FAIRNESS is with regard to the potential situation of what would happen in the event that DDKS were to dissolve as a Kansas non-profit organization (i.e. sell-out to a Delta from another state). We have proposed a provision that would require that their net assets would have to remain in Kansas and be distributed to other non-profits that provide dental care to Kansans. This money has been built up from Kansas dentists and Kansas taxpayers, and therefore, it should remain in Kansas to help Kansans.
We have proposed an amendment to make Board minutes Delta and financials available to member dentists upon request.
We have also proposed an amendment that would prevent them from using legal accounting camouflage to hide their true profitability. We would like DDKS to provide a breakdown showing the average of actual dollars paid out for dental services versus the amount paid in premiums for their fully insured enrollees. We want to see what the Benefit Distribution Ratio (BDR) is and not let them hide what they actually provide in percentage of benefits. Presently this is camouflaged under the industry title of Medical Loss Ratio (MLR) which contains many fees they pay to themselves but counted as benefit paid out. Many companies also include the pass-through money of self-insured (employer sponsored) plans as an expense to skew the numbers, making them appear less profitable.
FREEDOM OF CHOICE
We propose that Delta hold themselves to the same standard they impose upon dentists: to treat all their enrollees equally for benefits dollars and service. Delta requires dentists to treat all patients the same without regard for their insurance status.
We have proposed that DDKS provide uniform benefits, within a plan, to their enrollees, regardless of which dentist they choose to see. (Example: DDKS would not be able to lower a patient's benefit percentage from 100% to 80% for diagnostic/preventive services if they see a non-contracted provider.) A provision such as this is specifically addressed and allowed under the Non Profit Dental Service Corp statute under which Delta was formed. This provision would prevent DDKS from harming enrollees who choose to receive care outside of their network. What we are NOT saying is that Delta has to pay more in benefits to dentists. This is to help our patients. We just think patients should be able to fully utilize the benefits they've already paid for without being forced to see a dentist they may not want to see. If dentists benefit in any way from this proposal, it could come from the creation of a more competitive environment for DDKS to keep dentists in-network. And competition is a good thing in the insurance industry.
We'd like to have Delta, as a third party, partner with organized dentistry to push for legislative changes that incorporate all these manners of treating Kansans fairly with regard to their dental benefits.