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 the benefit package and promote goodwill. Broad Reach Benefits will design, implement and service your dental program to help your organization meet those objectives.
