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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.

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Fixing your dental problems can be a painful experience. But choosing a dental plan for your company should not be. There are five parts of every dental plan that you need to compare in order to 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 provide coverage for it at all. Similarly, while one plan may prefer may offer coverage of 80 percent of preventative care costs, another may cover the full amount. Carefully examining the list of coverage exclusions and limitations can help ensure that your employees do not run into any surprises when it comes to submitting claims.

Do not be fooled by percentages. While a plan may indicate that it will cover a set percentage of your costs, your employee may have to pay substantially more than the remaining percentage. This is because a UCR program, which is one of the most common plan structures, provides reimbursement for a treatment based on either the actual incurred dental charges or the "usual, customary and reasonable" costs that the plan determines are typical. The plan will then provide reimbursement based on the lower, less costly amount. To assess how reasonable a plan's limits are, it can be useful to compare the UCR allowances across plans for a set of routine treatments such as a cleaning, a filling, a set of x-rays or a root canal.

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Plans can also differ in terms of which dentists they are willing to reimburse. While you can always go to any dentist that you would like, you may not always get reimbursed for your treatments equally. Plans can either choose to accept all dentists or be more restrictive and limit reimbursement to certain dentists only. If your company is small enough, it can be a wise move to check the list of participating dentists for a given plan before agreeing to sign up.

Also, do not overlook the administrative requirements for maintaining the plan. Find out what flexibility you have in adding or terminating employees. Some plans are very restrictive and require the company to notify the plan immediately about any changes it would like to make. If this window is missed, you risk having an employee who cannot obtain coverage until the next open enrollment. Alternatively, you may potentially waste money by having to pay for coverage for employee who no longer works with your company if you do not report the termination in a timely fashion.

How much does a dental plan cost? Dental insurance rates range from $20 to $100 a month, depending on whether you see the coverage as an individual or for a family and according to how generous the coverage is. Rates will also be lower if your company has 50 or more employees so you can qualify for group discounts.

While the temptation may be great, avoid making a decision based on cost alone. With the right plan in place, you can keep your employees smiling.

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