Today, I’m excited to welcome Holly Frank and Robin Huff from Physicians Mutual. They’ll be sharing some excellent opportunities for your clients through Physicians Mutual’s products, particularly their dental plans. I really hope you find this information valuable. Without further delay, I’ll hand it over to them.

“Thank you, Elise,” Holly began. “We’re thrilled to be here and to have a partnership with URL.”

She introduced their focus for the session: Physicians Mutual dental plans. Many of you may have seen their national commercials, possibly even featuring Benny the Wizard. The whimsical character has helped bring attention to a product that’s rapidly gaining traction across the country.

Holly began by emphasizing that their dental plans are available nationwide. On their U.S. coverage map, you’ll see light blue dots—shaped like little tic-tacs—representing the availability of their core dental plans. These include four plan options, along with an optional vision and hearing rider.

Other colors on the map represent additional products, and for those who also sell Medicare Supplements, she shared some exciting news: Physicians Mutual will be rolling out their Medicare Supplement portfolio in Pennsylvania next month. Additional training is available for anyone interested, and Holly reminded everyone that their dental certification sessions happen weekly. For those not yet appointed with Physicians Mutual, Elise can help you get started.

Turning back to the dental plans, Holly outlined what they would cover in the presentation: features and benefits of all four plan options, the optional vision and hearing rider, how to use the dental reference manual, and key dental terms. She also noted they’d walk through what the customer receives after enrollment. Several downloadable attachments, including the brochure and reference materials, were made available to accompany the session.

Opening the brochure, she pointed to the headline on the cover: “Did you know Medicare does not cover dental?” It’s an important reminder, but these plans are not only for Medicare clients. Individuals, families, and small groups are all eligible, regardless of age.

Holly then addressed the common question of how the plan works with small groups. While Physicians Mutual doesn’t offer traditional list billing, their dental product can be billed to an employer for up to 25 individual policies. In fact, she noted they’ve made exceptions beyond 25 in some cases, as long as the policies aren't submitted all at once. Employers who wish to cover employee premiums simply need to complete an automatic bank withdrawal form and a business owner waiver—both included in the session attachments.

She flipped to the inside of the brochure and zoomed in on the first page. “What I love about this dental insurance,” she said, “is that it covers over 400 dental procedures.”

Customers receive 100% coverage for preventive care when they see an in-network provider through the Emeritus Classic PPO network—a large and well-established network. However, the plan can be used with any dentist. While customers save more with in-network providers, they’re not restricted.

Preventive services are covered immediately. Basic and major services are available after a 12-month waiting period, which helps prevent misuse of the plan—such as someone signing up for a root canal and canceling the next day. Importantly, there are no deductibles and no annual limits on cash benefits. Unlike many plans that cap benefits at $1,000 to $1,500 per year, this plan allows continuous access to coverage with no annual maximum—a key feature that sets it apart.

Robin added that this plan can be used alongside other dental insurance. Because it’s an indemnity plan, there’s no coordination of benefits. That means clients can carry two dental policies simultaneously and receive payouts from both—though they’ll be paying both premiums.

Robin shared her own experience. Years ago, before joining Physicians Mutual, she purchased their dental plan because her employer's coverage only offered $1,500 per year. “Once I started needing crowns and root canals, that wasn’t enough,” she said. By adding Physicians Mutual coverage, she rarely paid out of pocket again. “It really made a difference.”

They then discussed the four dental plan options, which cover the same 400+ procedures. The primary difference between the plans is how much they pay. Premiums and coverage vary depending on the plan tier and whether clients opt for additional riders.

Holly explained that while the brochure doesn’t include pricing, a separate rate chart was provided. Rates vary depending on whether it’s an individual, couple, or family plan. Discounts apply for automatic bank withdrawals and for clients who also have a Medicare Supplement. For example, the top-tier Premier Plan provides 100% preventive coverage and 70% coverage for basic and major services—all for just $56.50 per month. It’s rare to find that level of coverage with no annual cap at such a competitive price.

The three lower-tier plans—Economy, Standard, and Preferred—pay flat dollar amounts for procedures. The percentages shown reflect average payouts based on the Emeritus network's discounted rates. For example, the Standard Plan pays about 40% of the discounted rate, while the Preferred pays around 55%. The Premier Plan is structured differently—it pays 70% coinsurance on basic and major services when using an in-network provider.

Even for out-of-network providers, the plans pay as though the dentist were in-network, based on the Emeritus allowable charges. However, clients will save more if their provider is in the Emeritus network. A link and instructions for checking dentist participation were included in the session attachments.

To clarify how the plans work in practice, Holly shared an actual example from her husband's 2019 dental bill under the Preferred Plan. He had a filling, two crowns, and core build-up—a total billed amount of $3,225. Thanks to the Emeritus network, those charges were reduced to $2,432. Physicians Mutual then paid $1,227 directly. Between plan coverage and network discounts, they saved over $2,000 on that single visit. Later that year, he had another crown covered as well—demonstrating the value of unlimited annual benefits.

Before moving on to the optional vision and hearing rider, Elise paused to take some questions from the chat.

One attendee asked how claims are processed, since it’s an indemnity plan. Holly explained that if the dentist is in the Emeritus network, they are required to submit claims and will be paid directly. If the dentist is out-of-network, they are not required to submit claims, but may still choose to. In that case, the client can also submit the claim themselves and be reimbursed directly. In situations where a client has dual dental coverage, and the dentist is in-network, the client might even end up with a credit at their provider’s office.

If the dentist is not part of the Emeritas network, the reimbursement check will go directly to the customer. In some cases, the customer may even receive more than the actual cost of their dental services, depending on the procedure and how it was billed. It's a good question and highlights how the plan can work in the customer’s favor.

Another question that came up was whether someone on the standard plan could upgrade to the premier plan, and if doing so would reset the waiting period. The answer is no, it wouldn’t. Clients need to have their plan for two full years before they can upgrade. Once that two-year mark is reached, they can upgrade at the start of their next billing cycle without having to restart any waiting periods.

Someone also asked if the plans cover implants. That's a great question. Physicians Mutual offers up to a $1,000 lifetime maximum toward the implant post itself. However, there’s no limit on the supporting materials associated with the procedure—such as crowns. Those are fully covered according to the policy's benefits, provided the client has met their waiting period. The only exclusions to keep in mind are for cosmetic dentistry and the missing tooth clause. That said, we do cover dentures, as long as the individual has at least one tooth in each quadrant.

As for waiting periods and credible coverage: even if a client has continuous, credible dental coverage elsewhere, our 12-month waiting period for major services still applies. This is because we don't require members to sign a contract. They can cancel their plan at any time, unlike many other dental insurers that require a 12-month commitment. So to prevent someone from signing up, getting an expensive procedure like a root canal the next day, and then canceling, we enforce that 12-month wait for major services. That said, preventive care such as exams, cleanings, and x-rays, as well as basic care like fillings and extractions, are covered from day one.

Another follow-up question about implants asked whether the $1,000 maximum applied per implant or in total. That $1,000 is a lifetime maximum for the implant post—not per implant. But again, there is no limit on the before-and-after care, like crowns or adjustments, which is something many other dental plans don’t offer.

Robin shared her experience living in a rural area. Even though the Emeritas Classic PPO Network includes over 500,000 participating dental providers nationwide, in very rural regions, there may be fewer dentists available—perhaps one every 30 to 40 miles. In those cases, many dentists don't feel the need to join a network. That’s what makes this plan particularly attractive. Physicians Mutual will pay any licensed dentist, even those not in the network. And in most rural areas, dentists are still willing to file claims with us, even if they’re not in-network. If not, the customer can simply pay out of pocket and submit the claim for reimbursement directly.

That flexibility is a major reason this plan is so well-received. There's no annual cap on benefits and no network requirement for reimbursement. Even specialists like oral surgeons, who patients are often referred to, can be covered—even if they're out of network. It gives customers and providers peace of mind. In fact, Emeritas even accepts pre-treatment estimates from both in-network and out-of-network dentists, which is helpful when clients want to know ahead of time how much coverage they can expect for an upcoming procedure.

At this point, Holly introduced the optional Vision and Hearing Rider. This rider is available for just $8.95 per month and provides excellent value. It covers up to $100 per person per year for eye exams, and after a three-month waiting period, up to $150 for vision correction, including prescription glasses, sunglasses, sports glasses, spare pairs, or contact lenses. Additionally, it covers $75 per person for hearing exams, and after a 12-month waiting period, up to $500 per hearing aid—per year.

If clients choose a provider within the VSP (Vision Service Plan) network, they can access even greater discounts. For example, they’ll receive 20% off comprehensive eye exams, glasses, and sunglasses, 15% off contact lens exams, and up to 20% off laser vision correction surgery. It’s a strong value-add for such a low additional monthly cost.

The brochure also includes a helpful QR code that links to a short video. It's a simple and informative commercial that explains how the dental plan works and emphasizes the savings clients can receive by using in-network providers. If you're presenting the plan to a client and want to take a brief pause, or if you're new to presenting Physicians Mutual, it's a great tool to have on hand.

Next, the conversation shifted to how to find an Emeritas network dentist. By entering a ZIP code on the search tool, users can find up to 200 providers nearby. However, that list is capped at 200, so it’s important to use the most specific ZIP code available to ensure your client’s dentist appears in the search results. For instance, if a dentist is located across town and the ZIP code you enter is from the opposite side, the dentist might not show up in the results—even if they’re in the network. The search tool defaults to showing the 200 providers closest to the ZIP code entered.

Dentists shown in green on the results page are considered the most cost-effective. These providers typically offer additional discounts—even on non-covered services. This can be especially helpful if a client needs a procedure before the 12-month waiting period is up. However, it’s important to note that even if a dentist is not in green, they are still considered in-network and eligible for coverage.

Now, regarding the Dental Reference Manual—this is a tool specifically for agents. It lists all 400+ covered procedures and outlines how each one is reimbursed across the four available plans: Economy, Standard, Preferred, and Premier. It's organized by benefit type—Type I (Preventive), Type II (Basic), and Type III (Major). This manual is not something clients receive. Instead, after enrolling, clients will receive a policy packet that includes an ID card and a schedule of benefits specific to the plan they selected. Giving them the full manual could cause confusion since it includes all four plan levels.

To help with navigation, Holly covered some of the terminology that agents may encounter. For example, an "oral evaluation" refers to an exam—either comprehensive for new patients or periodic for existing ones. "Prophylaxis" refers to a cleaning, while “amalgam” is the term for silver fillings, and “resin-based composite” refers to tooth-colored fillings.

If a client asks what a procedure will cost them, you can offer a general range based on the filling type and tooth location. However, if they want exact numbers, it’s best to recommend a pre-treatment estimate. It’s easy for the dentist to submit, and it provides clarity to the customer on what their out-of-pocket costs will be. Holly mentioned she would show that pre-treatment estimate form in an upcoming slide.

She wrapped up this section by transitioning into a deeper discussion of major services, beginning with periodontal scaling and root planing.

Deep cleaning, also known as scaling and root planing, is considered a major benefit under the plan. Once this procedure has been performed, it’s typical for patients to require three to four cleanings per year. However, it’s important to understand that our policy only covers two cleanings annually. If additional cleanings are needed, the patient will be responsible for those out-of-pocket.

We previously discussed the $1,000 lifetime maximum for titanium implant posts. Now, to illustrate how coverage works, let's walk through a preventive services example. Preventive care is covered at 100% when the member sees an in-network provider. The service amounts shown are based on national averages. Even if the member chooses to see a provider outside of the network, our plan will still pay as though the dentist were in-network. That said, if their dentist is not participating in the network, they won’t receive the network discount and will be responsible for paying the difference themselves. Despite that, the plan still helps by contributing toward all covered procedures.

A more detailed example shows how basic and major benefits apply, depending on which plan the client chooses. In this example, the plans are displayed from Economy to Standard, Preferred, and Premier. As expected, the Premier plan pays the most, which means lower out-of-pocket costs for the customer. While no dental insurance plan covers everything, these plans help offset costs significantly. For those who are uncertain about whether to enroll, even the Economy plan, which starts at just $30.50 per month, can offer solid value. It includes two cleanings per year, exams, x-rays, and provides some assistance with basic and major services. It also includes one of the key features across all our dental plans: no annual maximum on benefits. What differentiates the Standard, Preferred, and Premier plans is that they simply pay more toward those services.

Once enrolled, members receive a dental ID card that includes a summary of benefits. It outlines key features such as no deductible, no annual maximum, applicable waiting periods, customer service contact information, and how to file claims or verify if their dentist is in the network. If the member has added the Vision and Hearing Rider, they will also receive a separate card specifically for those services. It’s important for members to inform their vision or hearing provider ahead of time that this is not traditional insurance. While it’s more than just a discount plan, it functions differently from standard vision or hearing insurance. For vision services provided by a VSP network provider, members will receive discounts and also be eligible for flat dollar benefits. This includes help with vision exams, corrective eyewear, hearing exams, and hearing aids.

We’ve already discussed the dental plan upgrade option. Members who want to switch to a higher plan can do so at any time, and if they’ve been on the plan for at least two years, they will not have to restart any waiting periods. As mentioned earlier, members can receive a 5% discount if someone in their household has a Physicians Mutual Medicare Supplement policy. There’s also a $3 monthly discount available for those who choose automatic bank withdrawal. Additionally, we offer one rate for all ages. It’s worth noting that we expect the Premier plan to have a rate increase at some point in the future.

When it comes to the sales process, our most successful agents have found it helpful to mention the dental plan early in the conversation. Letting potential clients know all the ways you can assist them sets the tone for the rest of the presentation. Reintroducing the plan at the end of the conversation is also a key strategy. One transition line that’s especially effective during cross-selling is: “I want to make sure you have just as good coverage during retirement as you did during your working years.” Of course, if you work with people who are still employed, you may need to adjust that approach.

There are a few standout features that make our dental plan particularly appealing. It helps cover over 400 procedures. There are no health questions, acceptance is guaranteed, and there's no deductible or annual maximum on benefits. Once you’re contracted with us, you’ll have access to all the sales and marketing materials, including a dental video that you can pull up via QR code from the brochure.

From a service standpoint, agents are not expected to handle everything, but they do play a role in helping clients locate in-network providers, answer basic questions about billing, and explain how to upgrade or downgrade a plan. Agents are also welcome to help submit claims if the dentist’s office won’t — though any provider in the Emeritus network is required to file claims directly.

Clients are encouraged to contact their agent with questions, log in to the member website to view claim details, and reach out to their dental office for pretreatment estimates, pending procedures, or explanations of benefits. In-network providers are required to send in claims, while out-of-network dentists may not, and it’s the member’s responsibility to ensure claims are submitted.

If a client wants a pretreatment estimate before receiving services, they’ll need to ask their dentist to complete a specific form. On the bottom left corner of the claim form, there is a small diagram that some describe as looking like a stadium or a full mouth of teeth. Right above that image, there’s a checkbox labeled “Dentist Pre-Treatment Estimate.” The dentist should check this box if services haven’t been performed yet but the patient wants an estimate of what will be covered. If the work has already been completed, the dentist should check the adjacent box labeled “Dentist Statement of Actual Services.” Both uses rely on the same form, but the dentist simply selects the appropriate option depending on the situation. For more expensive procedures, it’s always advisable that the client requests a pretreatment estimate and verifies that the dentist is still part of the Emeritus network to avoid any surprises.

Turning to the Vision and Hearing Rider, it functions similarly to the dental plan in that members can use any provider. However, there are added savings when they see VSP providers for vision or use specific brands for hearing aids. The plan pays $100 annually for vision exams, $150 toward glasses or contact lenses, $75 for hearing exams, and $500 per year for hearing aids. Additionally, every Physicians Mutual policy includes a free ScriptSave prescription savings card, which can be used to get extra discounts on name-brand hearing aids like those from Beltone and Epic. While members are free to shop anywhere, those using the ScriptSave card can take advantage of these exclusive discounts. Many people have also found great value through retailers like Costco, which offers affordable hearing aid options as well.

During the final Q&A portion of the session, there were several good questions from agents. One person asked whether the 20% VSP discount is applied before or after the $150 allowance. The answer is that the discount is applied first, which means the allowance will stretch further when using a VSP provider. Another agent asked if there will be a dedicated enrollment URL for agents and clients. While this is not yet available, it is currently in development and expected in the near future.

A question came up about how Physicians Mutual dental compares with Emeritus plans. While a detailed comparison chart is not yet available, it was shared that Emeritus typically includes an annual maximum on benefits — for example, their Premier plan maxes out at $3,000 — while Physicians Mutual offers unlimited cash benefits with no annual maximum. Additionally, although Emeritus may offer some out-of-network coverage, it tends to be at lower reimbursement levels. Our marketing team is working on a complete side-by-side comparison of the top dental carriers, and that resource will be shared once available.

Another question addressed whether the plan must start on the first of the month following enrollment. The answer is no — coverage can begin on any day, even the same day as the application.

An agent also requested a copy of the document outlining the responsibilities of the patient, agent, and dentist. Although that specific page wasn’t included in the handout materials, it can be provided upon request.

Regarding availability, the product map showing where these plans are offered was included in the handouts. Physicians Mutual is expanding, and additional states are being added each year. Although the company has been around since 1902, it is still gaining ground in certain regions. This expansion is part of a long-term growth strategy, and more availability is on the horizon.

Finally, if you’re not already contracted, the process is simple. One contract gives agents access to all products in all licensed states. For those already connected with a upline or brokerage, onboarding additional agents under that structure is seamless and requires minimal effort. Contracting, support, and plan access have all been designed to make it as easy as possible to get started.

The session wrapped up with thanks from the team at Physicians Mutual and encouragement to reach out for more information or with any questions. The support team is available, contracting is quick, and agents are well-positioned to bring strong dental, vision, and hearing coverage to their clients.