Dental insurance is a key benefit for small businesses. But not all plans are created equal. Choosing the right dental plan for your small business requires an assessment of employee needs, coverage options and costs. Ultimately, the best dental insurance will be affordable and comprehensive for your employees. Trusted ratings and reviews can help you understand how a provider’s plans stack up against the competition.
Cost
Dental insurance is a costly investment for small businesses. Employee monthly premiums can quickly add up, and out-of-pocket costs are often even higher. This is why it’s important to consider how the various plan options will impact your business budget and your employees. The key to controlling costs is understanding how each carrier determines the value of their small business dental plans. In addition to the cost of the premium, the value of a project also includes network savings and cost protections. These are largely determined by how many dentists participate in the network and how much the insurance company negotiates with them to lower the price of procedures. These discounts can greatly impact utilization, but only sometimes the overall cost. In addition, a plan may require employees to pay a copay for some procedures or reach a deductible before they are eligible for any benefits. Choosing the right plan option will ensure your employees get the coverage they need without paying too much out-of-pocket costs. Another way to control costs is through a group dental savings plan, which uses group purchasing power to offer a low annual fee for access to a network of dental professionals. This is different from an insurance plan because it doesn’t include a reimbursement model where employees must submit paid receipts and claims to the plan administrator for payment. This type of plan is easy to manage and can be a more cost-effective alternative to traditional dental insurance.
Coverage
Dental insurance is important for small businesses, providing an affordable way to cover preventive visits while making other costly procedures like fillings and crowns more affordable. Most dental policies have deductibles, the amount the policyholder pays before the insurance provider starts to pay for care. The policyholder may also have to pay a coinsurance percentage of the bill, typically 20% to 80% of the total cost of treatment. Some plans do not have a deductible or coinsurance, and others may only have a copayment for certain procedures. Indemnity or fee-for-service dental plans have no provider networks and allow employees to visit any dentist, although they may have to pay a copayment and additional fees. Many of these plans have annual maximums, the amount the plan will pay toward a particular procedure within the benefit year, while others may have lifetime maximums. Some group plans have a maximum of only $1,000 or $2,000 for the entire plan year, which may be suitable for smaller businesses. Larger groups can look at mid-sized and larger group plans, which often provide more comprehensive coverage, including some orthodontic procedures such as braces. A quality dental plan should include several other features to help your employees maximize their benefits, including educational tools and helpful apps.
Access to Dentists
When deciding on dental insurance plans for your small business, look for carriers that offer large provider networks. In-network dentists can offer your employees various options and typically offer discounted rates for most procedures. The types of dentists in a provider network are also important to consider. Look for a plan with a mix of general dentists and specialists such as orthodontists and periodontists. These specialists can help treat complicated dental conditions. It is also essential to determine the unique needs of your employees. A survey or discussion can help gather insights into your employee’s dental care needs. This information can help you understand the type of coverage your employees need and what features would be most beneficial to them. In addition to traditional group dental insurance, many insurers offer group dental savings plans. These plans are similar to membership buyers’ clubs and typically require a low annual fee to access a network of participating dentists. They are a cost-effective alternative to traditional dental insurance and generally have lower or no deductibles, maximums or coinsurance requirements.
Plan Design
How your group dental plan is designed can significantly impact your out-of-pocket costs. Look closely at the deductible, coinsurance and coverage maximums. Also, consider whether the program runs on a calendar or fiscal year. The type of provider network and copay structure is another factor to consider. Some plans use a preferred provider organization (PPO) network, similar to a health insurance PPO. In contrast, others use a dental health maintenance organization (DHMO) network, identical to a health insurance HMO. DPPO networks tend to be much larger, so there is a good chance your dentist will be “in-network” with them. In addition, some dental plans use a table or schedule of allowance to determine how much they will pay for a given procedure. This is sometimes called direct reimbursement. The difference between the dentist’s fee and the plan’s “customary and reasonable” fee is the patient’s out-of-pocket cost. The type of plan you choose should be based on your business needs and the preferences of your employees. For example, if your employees have a high tolerance for cost-sharing and are interested in a wide range of network options, then a DPPO or DHMO might be the best option. Consider a traditional indemnity or PPO plan if your employees don’t care about a limited network and want to keep monthly costs low.
