Beware the Toothless Dental Plan Not all dental plans are created equally. Learn what to look for so you can provide your employees with the best insurance.
By Mie- Yun Lee
Opinions expressed by Entrepreneur contributors are their own.
Fixing your dental problems can be a painful experience. Butchoosing a dental plan for your company should not be. There arefive parts of every dental plan that you need to compare in orderto make a fair evaluation.
Most importantly, take a look at the services that are covered.While one plan may cover orthodontia, another plan may not providecoverage for it at all. Similarly, while one plan may prefer mayoffer coverage of 80 percent of preventative care costs, anothermay cover the full amount. Carefully examining the list of coverageexclusions and limitations can help ensure that your employees donot run into any surprises when it comes to submitting claims.
Do not be fooled by percentages. While a plan may indicate thatit will cover a set percentage of your costs, your employee mayhave to pay substantially more than the remaining percentage. Thisis because a UCR program, which is one of the most common planstructures, provides reimbursement for a treatment based on eitherthe actual incurred dental charges or the "usual, customaryand reasonable" costs that the plan determines are typical.The plan will then provide reimbursement based on the lower, lesscostly amount. To assess how reasonable a plan's limits are, itcan be useful to compare the UCR allowances across plans for a setof routine treatments such as a cleaning, a filling, a set ofx-rays or a root canal.
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Plans can also differ in terms of which dentists they arewilling to reimburse. While you can always go to any dentist thatyou would like, you may not always get reimbursed for yourtreatments equally. Plans can either choose to accept all dentistsor be more restrictive and limit reimbursement to certain dentistsonly. If your company is small enough, it can be a wise move tocheck the list of participating dentists for a given plan beforeagreeing to sign up.
Also, do not overlook the administrative requirements formaintaining the plan. Find out what flexibility you have in addingor terminating employees. Some plans are very restrictive andrequire the company to notify the plan immediately about anychanges it would like to make. If this window is missed, you riskhaving an employee who cannot obtain coverage until the next openenrollment. Alternatively, you may potentially waste money byhaving to pay for coverage for employee who no longer works withyour company if you do not report the termination in a timelyfashion.
How much does a dental plan cost? Dental insurance rates rangefrom $20 to $100 a month, depending on whether you see the coverageas an individual or for a family and according to how generous thecoverage is. Rates will also be lower if your company has 50 ormore employees so you can qualify for group discounts.
While the temptation may be great, avoid making a decision basedon cost alone. With the right plan in place, you can keep youremployees smiling.
