Dental Insurance
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Dental Insurance
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Dental Insurance Introduction Paper cuts and toothaches both hurt more than they should. But while the pain of a paper cut will diminish on its own, a toothache can take hundreds, if not thousands, of dollars before the pain goes away. Enter dental insurance. Once considered a big company perk, dental insurance has established itself as a must-have benefit. In fact, according to a Society for Human Resources Management survey in 1999, 83% of small businesses offer dental insurance.
Dental care contributes to the all-around
health of your employees. Low-cost preventive procedures, like
cleanings, contribute to the overall health of your employees, which
means a decrease in sick time. If cost is holding you back, consider this:
dental coverage is less than 10% of the cost of medical coverage --
it's more affordable than you might think.
Types of Plans
Dental insurance isn't cut and dried. There are different plans, and then variations within those plans. Take time to get to know each plan before making a choice. Most expensive: direct reimbursement plans This self-funded plan's greatest strength is that it's straightforward - employees are reimbursed according to a simple formula that does away with the complexity of deductibles and the like.
Unfortunately, even though this is the type of plan that the American Dental Association recommends, directly covering the cost of dental care can be cost-prohibitive for small businesses. Less expensive: indemnity plans
Premiums are set for the year with indemnity plans so as a business your costs are known. But as for your employees, costs are a little less straightforward.
Insurance companies generally use UCR (usual, customary and reasonable) rates to base their reimbursements to dentists-- if the UCR rates used to pay dentists is less than the dentist's rate, the patient can potentially be on the hook to make up for the shortfall.
Patients also need to pay a deductible, averaging $50, and then a portion of the remaining amount - what is known as a co-payment. An average plan covers 100% for preventive measures like cleanings, 80% for basic work like a crown or cap, and 50% for major procedures like oral surgery
Least expensive: managed care plans
Unlike the fee-for-service plans above, managed care plans do have cost-control measures and can be a little more affordable for small businesses.
The co-payment amount can vary according to procedure, though. While preventive procedures usually are performed without a co-payment, more advanced procedures will have higher co-payments.
There are two types of managed care programs. PPO. Preferred Provider Organization programs consist of a network of dentists. The dentists within the network have discounted their fees in order to participate in the plan.
Employees have to pick from this pool, or pay penalties (a higher deductible or co-payment) to go to the dentist not in the network.
DHMO. Dental Health Maintenance Organization plans work like PPO plans. Patients choose from a network of dentists.
Instead of just discounting their fees, dentists will perform specific treatments for free. Dentists are paid a fixed fee per individual-even if the patient never even receives treatment. In turn, the dentists will provide treatment for free (for something involved or for frequent visits by one individual, a co-payment or fee may be charged). What's Best for You? Because of their cost-control measures, managed care plans are an affordable choice for small businesses (DHMOs are cheaper than PPOs). And small businesses seem to agree; these plans are currently the most popular choice. However, although it's the cheapest for your business, it's not necessarily the best plan for your employees. They may have to wait a while for reimbursement. Also, certain major procedures may be limited in the number of times they are covered in a given period of time. But all and all, the pool of dentists in managed care plans are not just picked, but are screened and are top-rate. And the plan gives employees flexibility-they aren't prohibited from going outside the pool. Meanwhile, it's affordable for employers. Pricing How much you'll pay for your dental coverage completely varies, depending on number or employees, plan, employee contribution, and the cost containment you impose. You may also have employees that choose not to participate in a dental program, that will raise your premium. A normal annual coverage per patient is $1,000-1,500. Companies normally cover 25-50% of monthly premiums. Whichever plan you choose, you will need to make sure the program elements meets your needs, so don't rush your decision. With the right plan, you'll keep star employees where they should be: at your company. Buying Tips Uncover the coverage Dentist check up Low-budget alternative? Description of benefits Changing plans Communication is key
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