As you begin to build a dental benefits package to offer to your employees, you may consider including orthodontic benefits in your dental plan. Depending on the size of your company and the plan you choose, your employees may have a range of discounts on the cost of braces and other devices.
What Do Your Employees (And Their Families) Want?
When choosing a company dental plan, consider your workforce. Do you have employees that have never had dental insurance? If so, restorative and orthodontic care may be a priority.
Are most of your employees parents? Employees with children ages 8-14 may be thinking about braces for the first time and could benefit from orthodontic coverage.
Do your employees want to straighten their teeth or correct their bite? Although child-only orthodontia is more commonly offered, you may be able to include adult orthodontic benefits in your dental plan. Some dental carriers, like Delta Dental, will offer coverage for both traditional and non-traditional braces, such as Invisalign.
Is Orthodontic Care Important?
It may seem like orthodontic care is a cosmetic need. However, orthodontics can correct a great deal more than just crooked teeth. Here are some conditions that orthodontic care could improve for your employees and their families:
- Speech issues
- Sleep apnea
- TMJ
- Teeth grinding (bruxism)
- Chewing or bite problems
Adding Orthodontic Coverage to Your Company Dental Plan
Delta Dental of Arizona offers an orthodontic add-on for groups with as few as 2 enrolled employees. Coverage options may vary depending on your group’s size, so it’s best to work with your broker or a member of our sales team to learn more.
It’s also important to know that orthodontia has a separate maximum insurance benefit. This means that if you get braces, the cost is not subtracted from your annual maximum. Instead the cost is subtracted from your orthodontic lifetime maximum. Once you hit the orthodontic maximum, there is no more coverage and it will not reset. Having a separate maximum for orthodontic care means you will still have benefit dollars to use toward other dental care you may need.
Understanding the Value of Ortho Benefits
When you’re considering including orthodontics coverage in your company’s dental plan, it’s important to understand the overall value that the plan is offering. Consider this example in which a dental plan is covering 50% of orthodontics:
- Cost of braces: $3,000
- Dental plan covers 50% of orthodontics in plan year: $1,500
- Orthodontic lifetime maximum: $2,000
In this scenario, the dental plan covers $1,500. The employee would be responsible for covering the other half of the cost, which is $1,500. This would leave the employee with $500 left to use until they meet their orthodontic lifetime maximum.
Including orthodontic coverage means employees pay less for braces. In-network dentists agree to charge Delta Dental patients less money and the dental plan pays for some of the cost. However, premium rates for dental plans with orthodontic coverage may be higher.
Next Steps
Create a dental plan wish list that includes features that are important to your employees, such as orthodontic care. Then work with your broker or benefits consultant. Encourage your broker to move beyond a standard spreadsheet analysis and take a deeper look at plan design elements to ensure you are receiving the best benefits for your budget.
If you don’t have an insurance broker, here are some tips for selecting one.
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