Group Dental: a complex topic that may seem simple on the surface, but if you truly want to make an employer and employees happy, there’s more to it than rates.
Did you know that next to medical benefits, dental is the next sought after benefit?
It’s our opinion that it is better to offer it on a voluntary basis than not at all. This is one of the many benefits that can be deducted before taxes and still help the employer save money.
So why is dental not as simple as we may think? Let’s delve a bit into the inner workings:
- Maximum Annual Benefits
More often than not, the standard maximum annual benefit is usually $1,000, but are you aware there are options for $1,500, $2,000, and depending on the group size, even higher?
Tip: Some companies won’t count the preventative dollars used towards that maximum, which can help increase the actual benefit by several hundred dollars.
Ranging anywhere from $0 to $250 per person and up to three times per family, a carrier may often increase the family cap from 2 times to 3 times to be a bit more competitive in the marketplace.
Tip: Lifetime deductibles are an option to encourage a group to stay with a carrier. Once the lifetime deductible has been met per person and family member, no further deductibles are required.
- How are the benefits paid?
It’s important to analyze where Endodontics and Periodontics are paid. Together with surgery and anesthesia, these are means to get the pricing down (and lowering or raising benefits to the employees).
Tip: This is where a rate is not simply a rate and you are really doing your client a disservice if that’s all you are reviewing.
- What about networks & how they function?
Closed network HMO’s only allow a member (unless an emergency) to receive benefits from a listed provider, and referrals are required for specialist services to be covered. The same is true with some carriers when they quote a MAC (maximum allowable charge) plan or a DHMO (Dental HMO).
Tip: Comparing a carrier that quoted a MAC plan versus a UCR (usual, customary, and reasonable) would be a mistake. Let’s not forget that many individuals aren’t so lax to change dentists and if forced to do so may resent the employer and insurance carrier in the end.
- It’s all in the details!
Before you quote your next dental plan, make certain to take these variables into account. If this is a daunting task (which it can be if you are truly quoting the dozen or so carriers that are out there), please feel free to allow us to do the work for you. We will make the process painless and the sale will be easier than ever before.
We look forward to working with you on your ancillary group cases this year! Thank you for your loyalty and let us know what more we can do to help you in your group and disability solutions.