Wading through dental plan options for your company can be overwhelming, but employees will appreciate the added benefits. As you evaluate the different dental benefits available, you should consider the needs of those using the benefits and how they define high-quality coverage. This ensures that your company and its employees get the most value out of their dental benefits dollars.
Here are some tips on selecting a dental plan that will make both you and your employees smile.
Consider the age of your workforce. Age is an important factor in determining your employees’ dental needs, as different demographics have different oral health needs:
- Employees between the ages of 20-39 are less likely to have poor oral health. This age bracket is also more likely to have children. They appreciate tools that encourage kids to practice good oral health habits.
- Employees between the ages of 40-59 appreciate a dental plan that covers more restorative procedures.
- Those in the 60+ age range are more likely to face more complicated conditions and need a dental plan that covers full restorations.
Preventive care is key. While medical insurance primarily focuses on treatment, dental insurance focuses on prevention. That’s because most dental problems, such as cavities or gingivitis, are nearly 100% preventable with proper dental care. When reviewing different dental plans, find out what types of services are covered. Ideally, you’ll want a dental benefits plan that emphasizes preventive and diagnostic care.
Work within your budget. As an employer, it’s important to understand what your payment obligations are. Should your company self-insure its dental plan or purchase a fully-insured plan? With fully-insured plans, the employer pays the dental carrier fixed rates or monthly premiums per enrolled employee for access to a provider network, plan design and benefits administration. The dental carrier assumes all of the risk associated with the claims and if there are any unused premium dollars at the end of the benefit year, the dental carrier gets to keep them. With a self-insured or administrative services only (ASO) plan, the employer pays for claims costs as they incur but has more flexibility regarding plan design. The decision between fully insured and self-funded dental plans should be made with careful consideration of your company’s specific situation and an analytic comparison of costs and risk assessments.
Determine if there will be cost-sharing. Two ways that the cost of the dental plan can be shared between the employer and employees are through premium contributions and through co-pays, co-insurance, deductibles and annual maximums.
- With premium contributions, the employer will pay a portion of the premium and the employees will pay for the remaining premium through payroll deductions.
- A co-pay is a flat fee that the patient pays at the time of service.
- Co-insurance requires patients to pay a portion of the services they receive and is usually calculated as a percentage of the service cost after the plan pays benefits. For example, if the plan pays 80 percent of the cost, the patient pays 20 percent of the cost.
- A deductible is the amount that employees must pay before the insurance company pays for all or a portion of the costs. Deductibles vary, but plans with lower premiums typically have higher deductibles.
- Annual maximums are the maximum dollar amount a dental plan will pay toward the cost of dental care within a benefit year. In general, the higher the annual maximum, the higher the premium.
Pick a plan with a large network. How many dentists will be in the network locally? Do you have any employees that work in different states and/or regularly travel? An “affordable dental plan” isn’t a good value if it only provides access to a narrow network of dentists. In fact, having more in-network dentists to choose from improves network utilization rates simply because more employees are visiting an in-network dentist. In most dental plans, claims costs account for the majority of the employer’s expense. Network utilization is the primary means of controlling claims costs.
Regardless of the dental plan you choose, making the decision to give your employees dental benefits is the right choice. People with dental benefits exhibit more healthy behaviors and better oral health habits and are less likely to smoke, according to a 2009 report by the National Association of Dental Providers.
If you still have questions about choosing a dental benefits plan for your business, reach out to a local consultant or broker. For information on Delta Dental of Arizona’s group dental plans for employers, visit DeltaDentalAZ.com.
