Dental insurance is a popular employee benefit. If you're considering offering it, the American Dental Association (ADA) reminds you that dental benefit plans are often designed differently than medical plans. The most common include:
Direct reimbursement. This is a self-funded, freedom-of-choice plan, which reimburses claims at a fixed percentage of the total cost.
Usual, customary and reasonable (UCR). Also a freedom-of-choice plan, UCR programs pay the benefit as either a set percentage of the dentist's regular fee or the amount determined to be "customary" or "reasonable."
Table of allowance. This type of program specifies a maximum dollar benefit for each covered procedure, regardless of the fee charged.
Preferred provider organization. Participating dentists agree to discount their fees as an incentive for patients to select their practices.
Capitation. These programs pay contracted dentists a fixed amount per enrolled family or patient.
For more information on choosing a dental plan, contact the ADA's Council on Dental Benefit Programs, Purchaser Information Service, 211 E. Chicago Ave., Chicago, IL 60611, or call them at (312) 440-2746.