Aflac Complaint - Aflac Dental Policy: Not Worth It

Posted by saj80 on 2009-03-09:

Isn't AFLAC just supplemental insurance? If so, then they have set amounts they will reimburse for.

Posted by AFLAC Dental: Not worth it on 2009-03-14:

Yes it is supplemental, however their amounts they reimburse you for are still way too low.

Posted by Nohandle on 2009-03-14:

I don't have AFLAC, but the company I'm with offers it to those employees interested. It is intended as a supplimental, not primary insurance. If anyone feels the amount paid for a claim is not adequate then by all means cancel the coverage. I have a co-worker who was treated for thyroid cancer. Her Blue Cross paid for her surgery and follow up treatments, sick pay took care of her lost wages and AFLAC sent her a check which was far more than the premiums she had paid through the years.

I'm curious AFLAC dental, does AFLAC state the amount they will pay for a given claim in their policy?

Posted by timjdd on 2009-06-15:

Aflac Dental has different levels of coverage, the cheapest of which is intended to be a supplement to other dental insurance (most group plans have very low annual limits on benefits, thus the need for a supplement for some employees who anticipate heavy use of dental insurance). Because Aflac is sold as an individual, not group, policy, there are waiting periods on all but the most basic of benefits (the $75 the rater received was most likely a Wellness or X-ray benefit which is not subject to a waiting period). The policy itself spells out exactly how much it will pay for each American Dental Association (ADA) code that typical dentists use in filing claims with any insurance company. When dental insurance is offered as an individual and not a group policy, the insurance company already knows that only people who intend to use the coverage in the near future will sign up, intending to keep the insurance only so long as they are undergoing treatment. Once treatment ends, many people simply intend to cancel their coverage, meaning that they will have received far more in benefits than they ever paid in premiums. Since this is an obvious losing proposition, Aflac imposes waiting periods for actual dental treatments, and the more extensive and expensive the treatment, the longer the waiting period. I suspect the original rater filed a claim for services performed before the waiting period had expired. A good agent would have explained in detail the concept and need for waiting periods during the sales presentation and before any buying decision had been made (that is, if he or she wanted to actually maintain good client relations--the waiting periods are the most glaring potential minefield for client dissatisfaction).
I have been an Aflac agent for over 12 years, and only a very few of my employer clients use our Dental options. While they understand that their employees want to have a dental option, they are not willing to pay for a group plan, because the vast majority of group plans impose guaranteed levels of employee participation (some as high as 60-70%) which are difficult to achieve with voluntary products, as there are rarely that many employees expecting to need dental work at any one time, and so they don't choose to spend their money in that way.

Posted by HD on 2012-03-18:

Hi, thank you for this review - so far I've found its just easier to pay for the whole thing in cash. Insurance seems a waste of time for sure.