Maximum Benefit Bonus

February 4, 2012

Earn Rewards for Smart Choices

Enrollees who pay attention to their oral health, with an emphasis on diagnostic, preventive and simple restorative procedures, traditionally have to leave unused annual maximums behind. With Delta Dental of Wisconsin's Maximum Benefit Bonus (MBB), a portion of the member's unused annual maximum is placed in a special MBB account and can be used in future years. This option offers enrollees more flexibility and helps them if they need more extensive and costly dental treatment later.

What groups/members are eligible?

• Maximum Benefit Bonus (MBB) is available as an option to groups that offer an annual maximum between $1,000 and $2,000, and are either self-insured or individually rated, fully-insured groups.
• The member is required to have been covered under the plan for at least one full benefit year, with coverage for major services.
• The member is required to have completed any benefit waiting periods included in their plan before beginning to accrue MBB benefits.
• The member must have submitted at least one claim for a covered service (nonorthodontic) during the benefit year.
• The total cost of the claim(s) applied to the member's annual maximum must be below 50% of the member's annual maximum.
• The MBB allowance varies on the basis of the plan's annual maximum (see table below) and whether or not all services were provided by a Delta Dental PPO dentist. The allowance is 35% of the annual maximum if all of the member's claims came from a PPO provider and the group has a PPO plan, and 25% of the annual maximum if all or some of the claims came from a non-PPO provider, or if the group does not have a PPO plan.
• The total amount available in the member's MBB account can grow to an amount equal to the plan's annual maximum.
• Each covered family member will have their own MBB account.

Determining the Maximum Benefit Bonus allowance

• The table below lists the Maximum Benefit Bonus allowances, based on the plan's annual maximum. Remember, the MBB allowances for PPO occur only if the group has a PPO plan, and all services are provided by a Delta Dental PPO provider.

Plan Annual Maximum	MBB Allowance - PPO	MBB Allowance - Non-PPO
$1,000	$350	$250
$1,200	$420	$300
$1,250	$438	$313
$1,500	$525	$375
$2,000	$700	$500

Click here to download a brochure about Maximum Benefit Bonus.