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When Manhattan raised their rates a few months ago, they went to paying on usual and customary charges, but Chaz and I are still on Actual Charges. Any new policies issued are usual and customary charges. Hated to see them make that change, but it's still the best plan. I think almost everybody else pays on usual and customary charges. UNL pays on Actual charges.So it really isn't 60% of everything.
Unless this carrier has figured out a way to do something no other carrier has, or you just happen to use inexpensive dentists, the "percent of everything" plans won't make it.
I sold Hoosier Dental plans years ago, both group and individual. They had percent plans as well but it was a percent of their own fee schedule.
Their premiums were higher than similar plans but so were their fee shedules.
Competing plans had lower premiums but typically left policyholders with a lot of OOP and complaints about things that were not covered.
There really is no majic to the insurance business. When a carrier pays out more than it takes in the carrier or the plan goes away.
Not being argumentative, but 2 claims is not a statistical sample.
Fluoride treatments aren't covered until you've had the policy a year. Chaz should've waited a little longer and they would've covered it and everything else he had done at 70%, instead of 60% of the Actual Charges.