Direct Reimbursement Self-Funded Dental
FACT SHEET
Do You Really Need "Dental Insurance" for Your Dental Plan?
Insurance as we know it is designed to protect against unpredictable and catastrophic losses.
Dental care is uniquely different. It is highly PREDICTABLE and the claims dollars are relatively small amounts. Adding to the predictability of dental costs are annual maximums or caps placed on coverage thereby minimizing the risks. Most annual caps for dental care are $1,000 - $1,500.
CONSIDER THESE FACTS
Dental patients don't overuse dental benefits
40% of employees with dental coverage will never see a dentist
The remaining 60% of employees who do use their dental benefits average claims costs of $168 per individual and $300 per family per year
Of the 60% of employees that use their dental benefits, only 5% will reach their maximum in any given year
You can easily see that these average costs are a fraction of the premiums you pay for dental insurance each year.
EMPLOYER/EMPLOYEE BENEFITS
COST SAVINGS - With a self-funded dental plan the employer keeps the dental premiums and pays the dental expenses when and if an employee visits the dentist.
FLEXIBILITY - Employers design their own plan to suit their employee demographics. Employers with multi-state locations can offer the same plan to everyone.
FREEDOM OF CHOICE OF DENTIST - With a self-funded plan, participants can choose any dentist. No networks or restrictions.
NO EXCLUSIONS (other than cosmetic care), no pre-determination of treatment.
DOLLAR BASED BENEFITS - Self-funded plans use dollar based benefits rather than "procedure" benefits. This means the coverage amount is based on the actual cost of treatment rather than the type of treatment.
Click here to calculate your own savings
Employer Groups Using Self-Funded Direct Dental
HOW IS THE PLAN ADMINISTERED?
A Third Party Administrator (TPA), can handle your claims payments, determine eligibility of participants, provide the required plan documents, ID cards and can provide you with detailed claims reporting. By using a TPA, the employer doesn't have to allocate any of their personnel resources to the plan.
NOT CONVINCED?
If you're considering a self-funded dental plan but not quite
convinced it's the right choice, I challenge you to do just one thing. Pick up
the phone and call our current dental insurance company and ask them to provide
you with a detailed claims analysis. Once you get your claims report compare the
claims paid to the amount of premium you sent to the company. You'll be very
surprised!
Remember, the insurance company is looking out for their bottom line,
not yours!!
Warning: In almost every case
your dental carrier will tell you they don't have the information you want.
When You're Ready, Just Give Us A Call
MIKE EDWARDS BENEFIT GROUP INC.
800-463-8020