Dental insurance is currently ranked as the #1 benefit requested by employees after health insurance. Dental plans can be paid for by the employer, the employer and employee or on a completely voluntary, payroll deducted basis. With many employers cutting back on employer funded benefits the voluntary plans have become increasingly more popular.

There are many different types of dental plans available (click on each for more info):


Century can provide your company with a detailed description of each type of plan, and work with you to design and implement a plan that satisfies both the needs of your company and employees. Whether you need a dental plan that is employer paid, contributory or voluntary, we can provide several options that will meet your needs. Many times a combination, or choice of plans, will be offered so that you have options to satisfy your dental needs.


Indemnity Plans< top >

Indemnity plans are by far the most popular and well-liked designs by employees and employers. Insured can visit any dentist nationally so there is never a question of whether the family dentist is "in the plan". Additionally, dependents away at school, employees traveling and employees in companies with multiple locations always have access to dental care.

Ask any dentist which of the above plan types they prefer and the answer is always the indemnity plan design. The key is to make certain the dental plan pays claims at a high level of reasonable and customary (80th -90th percentile).

  • Choice of ANY dentist! (No networks or lists of dentists)
  • Preventive services covered 100% - No deductible
  • Lower participation limits
  • No employer contribution required
  • Claims paid direct to dentist or employee
  • Claims based on the 80th - 90th percentile of UCR
  • Low group premiums
  • Pooled risk products
  • Two year rate guarantees
  • Top rated insurance carriers


Preferred Provider Organizations (PPO)< top >
Adding a Preferred Provider Organization (PPO) to a traditional voluntary dental plan lets the insured choose a dentist from the nationwide network of participating dentists. Of course the insured can still receive care from any dentist they wish, whether they participate in the network or not. If the insured selects a PPO dentist they will receive care at discounted fees (typically 20%) and be assured of no balance billing above the negotiated fees. Should an insured visit an out of network dentist they may be required to pay the dentist at time of service and file for reimbursement from the insurer. They are also reimbursed at a lower percentage and will most likely be balance billed for the remaining balance.

  • Visiting a PPO provider will reduce treatment costs compared to a traditional plan.
  • No balance billing above the covered amount.
  • No referrals are needed to see a PPO dentist, even for specialty care.


Managed Care Dental Programs (DHMO)< top >
Managed dental care plans are designed to offer employees and their dependents a broad range of services through a network of providers while helping to reduce dental care costs.

Each insured selects a personal dentist from the directory of participating dentists. Each covered member of the family may select a different dentist. Benefits may be significantly reduced if the insured uses a dentist who does not participate in the network.

  • No annual maximums
  • No annual or lifetime deductibles
  • Higher benefit levels than traditional plans
  • Low out-of-pocket expenses compared to traditional plans


Freedom-of-Choice Programs< top >
Century is a recognized industry leader in Voluntary Dental Programs. Based on years of feedback from employers and employees throughout the country, we designed a unique voluntary dental program. The program allows employees to receive dental care from either a traditional indemnity plan or a managed care program (the DHMO).

Insured can actually switch back and forth between the indemnity plan and the managed care plan during the year by making a simple phone call to a toll free number. This change takes place without any intervention by the employer’s benefits department! This flexibility provides the insured with the ability to continue to use their own family dentist or utilize the services of a DHMO provider for increased savings. The plan also incorporates a preferred provider network on the indemnity side for additional savings.

The program works especially well for groups of employees spread out across the country. Access to a dentist will never be an issue since the insured can use the national DHMO network or simply choose the alternate program and use any dentist in the country.


Direct Reimbursement Plans< top >
Direct Reimbursement dental plans are self-funded by the employer. They provide complete flexibility in benefit design. These plans reimburse patients according to dollars spent on dental care, not the type of treatment received. Patients have the freedom to choose any dentist.


Dental Plans Continued...
Below are just a few of the issues that need to be examined when looking at the design of dental programs and the carrier that will insure and administer the program. We’ve learned that truly successful dental plans have to please the employer, the insured as well as the dentist.

Access
Most people become very comfortable with their family dentist. People are very particular about who is putting their fingers in their mouths! For a dental program (especially an employee paid plan) to be a complete success, your employees must have access to the dentist of their choice. Dental plans that require the insured to use a limited list of providers can create access problems if your organization has more than one location, sales people on the road or dependents away at college.

Participation
The minimum participation needed for voluntary dental plans is 20% of the eligible workforce. Voluntary programs that require 50% or higher participation run the risk of not meeting participation. The average enrollment percentage for our clients is 60%. This is substantially higher than the industry average. We credit this to our educational, not sales oriented enrollment process.

Solid Plan Design
Some dental plans have "holes" in the coverage. As an example, one very popular program covers only one exam per year. Dental programs should cover two cleanings and two exams per plan year. Proper plan design ensures employee satisfaction and promotes quality dental care.

Employer Costs
For voluntary dental programs no employer contribution is required towards the premiums. Some employers will subsidize the cost but it is never required. The only employer costs are those associated with the administration of the plan such as the additional payroll deduction, forwarding premium each month to the insurance carrier and adding/deleting employees each month. These costs are offset by the savings the employer receives as a result of the reduced payroll taxes from the Section 125 plan.

Claims Payments
Many dental programs look the same on the surface but have premiums that are vastly different. Examine how the carriers are reimbursing the dental providers. Well-designed indemnity plans reimburse the dental provider based on reasonable and customary charges, not a fee schedule. This reimbursement should be based on where the service is performed (the dentist's office location) and the charges should be paid at the 80th – 90th percentile of reasonable and customary. Claim data should be updated every six months to stay current.

Plan Designs for Virgin Risks
Companies that put in virgin dental programs (new dental plans with no prior coverage) experience extremely high utilization in the first year. Clearly, everyone who needs dental work will immediately rush to their dentists as soon as the plan starts! As a result, virgin dental programs need to be designed to deal with this adverse selection. Dental plans that don't tend to incur excessive premium increases after the first year. Properly designed plans can expect normal dental trend.

Rate Guarantee
Rate stability. Many plans come with an initial two-year rate guarantee.

Claims & Customer Service
Timely and efficient handling of claims is one of the factors that will affect how employees perceive their benefits. Dental claims can be highly automated which save the carriers administrative dollars. The carrier needs to be turning claims around quickly and be responsive to all customer service calls.

The Bottom Line
Dental programs need to perform at a high level to keep all insured satisfied. Employers that implement dental programs are doing so to provide a much desired benefit, enhance their benefit package and promote goodwill. Century will design, implement and service your dental program to help your organization meet those objectives.