Types of dental insurance plans for employees

A dental insurance is an insurance that will provide the person having dental insurance protection with required financial assistance for normal dental care and damage occurred to teeth from accidents, this can be under an individual or group insurance plan. Dental insurance was once a neglected area, but the awareness about importance of dental insurance is increasing alarmingly. In the past dental insurance was treated only as a perquisite provided by the company to its employees, studies (Human Resource Management Survey-1999) show that 83% of the small business provides dental insurance to its employees.It’s advisable for every one to go for dental insurance. Dental insurance is more affordable and cheap when compared to other medical insurance. In fact dental insurance costs less than 10% of the cost of the medical coverage. Like every other type of insurance dental insurance also offers a number of plans that you can select from. The major types of dental insurance for employees are discussed below: Direct reimbursement planThis plan works on the amount that the company set aside specially for this purpose. In this plan the employees are reimbursed the money that they have spent for dental care. The most positive aspect of this pan is that it is straight forward and not involves any complex calculations. This plan is widely recommended by American Dental Association. Direct reimbursement plan is considered as most expensive for the employers. Certain small business finds it difficult to go in tune with this plan because of the cost factor involved.Indemnity plansThese plans are more feasible. Under this plan the amount of premium is paid to the insurance company and the company in turn pays the amount to the dentists for their treatment. Under this plan the insurance company generally uses UCR (usual, customary, and reasonable) for making payment to dentists. In case if the UCR rate used to pay dentists falls short of dentist’s rate, the patient has to make up the shortfall. The insurance coverage under this plan are 100% for preventive measures like cleanings, 80% for basic work like a crown or cap, and 50% for major procedures like oral surgery.Managed care plansThese plans are treated as the least expensive. These plans include some cost control measures and are best suited for small business. This plan wants the patients to pay a certain amount as co-payment and the co-payments vary according to the procedure. Preventive procedures are normally performed without a co-payment and advanced procedures are carried out with a higher co-payment.The managed care programs are of two types, they are:a. Preferred Provider Organization (PRO) ProgramPreferred provider organization program consists of a network of dentists. The dentists who fall under this plan have reduced their charges with a view to participate in this plan. The employees can select the dentist from this pool, if the employees have to go to a dentist not in this pool they have to pay penalties.b. Dental Health Maintenance Organization (DHMO) PlanIn this plan also the employees have the right to choose the dentist from the pool, but in this plan instead of discounting the fees the dentists provide certain treatments free of cost. The dentists are paid a fixed amount as fees per individual even if the patient never ever receives the payment.The above stated are the various plans of dental insurance provided by the employer to the employees. It is possible for the employees to select the best suited plan after analyzing the advantages and disadvantages of the available options. By selecting a proper dental insurance it is possible for the employees to assure the health and safety of their teeth.

Types Of Dental Insurance


There are several basic types of dental insurance plans offering a range of cover from the most basic dental care plans to complete all encompassing dental insurance plans.
Basic dental care plans aren’t effectively an insurance but rather a ‘club’ that enables you to obtain discounted dental care from participating dentists. The level of discount is largely dependant on the monthly fee you pay but unlike dental insurance there is no limit to the amount of discounted treatment you can receive. One thing to check with dental care plans is the amount of local dental coverage (if any!). You can join a dental care plan for just a few dollars a month.
Indemnity Insurance Plans are a type of dental insurance whereby you pay the insurance company a fixed monthly fee who, in turn, will reimburse your dentist for services rendered. However, the dental insurance company doesn’t normally cover the whole cost with the policy holder be liable for 20 – 50% of the total cost. If you take out an indemnity plan you need to check the level of deductibles and the maximum amount the insurance policy will pay out in any given year. Also find out the length of any probationary period during which the dental insurance company won’t pay out and whether you are able to use your own dentist. Expect to pay around $14 to $26 per month.
One of the increasingly popular dental insurances is the direct reimbursement plans which are self funded by employer’s rather them paying dental insurance premiums. As a general rule the person receiving the dental care will pay the fee in full and reclaim all or part of the cost (depending on what level of cover their particular employer provides) from their employer. Annual benefits of this dental insurance option are usually capped with the capped level varying quite significantly from one employer to another
Capitation dental insurance plans (HMO’s) are when the dentist is paid an annual fee per patient rather than on a treatment basis. However, the dental insurance policy holder may be required to contribute towards the cost of any treatment. The cost of HMO insurance plans are generally targeted at preventative and emergency care and can vary from patient to patient following an initial examination.
Preferred provider organisations (PPO) offer an insurance plan that allows you to visit dentists from a preferred supplier list at a heavily discounted rate. If you choose to use a dentist that is not covered by the dental plan you will still receive some element of discount but nowhere near as much as you will receive from a ‘preferred’ dentist. As with most dental insurance plans an annual cap will apply. Expect to pay up to about $25 per month.
UCR (Usual, Customary & Reasonable) indemnity dental insurance plans have a database which contains average prices for each dental procedure you might undergo. When you submit your bill for payment the dental insurance provider will check the cost of your treatment against the average. If you paid more than the average you will have to incur the additional cost with the insurance company only paying the insured percentage of the fee shown in their database. If the cost of your treatment is lower than average you will receive the agreed percentage of the amount you paid. There is no control over how dental insurance companies calculate the UCR cost and the insurance company always pockets the benefit of lower fees.