The Surprising Truth About Dental Insurance and What To Do About It

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Many employers include dental insurance in their benefits packages. Why? Because employees want it.

According to a survey of employees published in Harvard Business Review, better health, dental and vision insurance are the benefits most valued by employees, with such perks as more flexible hours, more vacation time and work-from-home options all trailing behind.

Even though many Americans currently have dental benefits, a surprisingly high number do not. According to industry statistics, approximately 23 percent of Americans have no dental coverage, which translates to about 74 million people in the U.S.

Not only that but according to the Centers for Disease Control and Prevention, more than a third of American adults haven’t seen a dental professional in the past year. Why not? According to the American Dental Association, 40 percent of adults who didn’t visit a dentist in the past year said they didn’t go because of cost.

And for employees who have neglected their dental health for a long period of time, the costs can really add up. While a simple checkup costs only an average of about $85-$100 in the U.S., fillings run approximately $230-$300, and crowns go for $1,100 and up. For Americans without dental insurance, these expenses can cause them to put off needed dental procedures and even annual checkups.

Studies show that people who do not have dental benefits are more likely to have teeth removed—resulting in expensive and troublesome dentures. They are also less likely to visit the dentist regularly and less likely to be treated for gum disease. Not only that, but people who do not have dental benefits are more likely to suffer from other, non-dental-related diseases:

  • 67 percent are more likely to have heart disease.
  • 50 percent are more likely to have osteoporosis.
  • 29 percent are more likely to have diabetes.

As a business owner, executive or manager, you want your employees to be as healthy as they can be, and this includes their dental health. Healthier employees are happier and more productive, and they provide better service to customers and clients.

You’re in a unique position to help your employees become healthier and happier by providing them with dental benefits that can put affordable and quality dental care firmly within their reach.

By offering a comprehensive health and wellness package that includes dental insurance, you can improve employee retention and better attract prospective candidates. This allows you to be much more selective when you’re recruiting for open positions, upping the quality of your new hires and the productivity of your entire organization.

These are all good outcomes for your customers—and for your bottom line. To get you started on the right path, here are the four major types of dental insurance that employers can consider.

1. Preferred Provider Organization

PPOs are the most popular type of dental plan for employers.  They parallel regular medical PPO plans in negotiating lower rates with preferred dentists in their network. Some PPOs even cover visits to an out-of-network dentist for a higher co-pay. Most PPOs are "100-80-50" plans: When an employee goes to a preferred provider, the plan covers 100 percent of preventative services, 80 percent of certain basic procedures, and 50 percent for major services such as crowns.

However, not all procedures are covered, and PPOs frequently have a calendar-year maximum and deductibles. Most of these plans also have waiting periods for complex procedures such as crowns, to prevent people from signing up just to get major dental work and then canceling when the ordeal is over.

2. Health Maintenance Organization

HMOs for dental care, like medical HMOs, offer a closed network of dentists. These plans have no waiting periods or deductibles, and no annual maximum on benefits or claim forms to fill out. Dental HMOs are excellent for preventive services, such as cleaning and X-rays, which are typically covered at 100 percent. Most other covered procedures require a co-pay. However, these types of plans tend to limit major and/or restorative procedures. They often pay 50 percent or don't cover the procedure at all.

3. Indemnity Dental Insurance

Also known as “traditional” insurance, dental indemnity insurance plans operate under a “fee for service” structure. The main advantage of an indemnity plan is that it allows employees to visit any dentist. Indemnity plans pay a set amount based on a pre-calculated “usual, customary and reasonable” fee. Very often, employees must pay an additional amount out of pocket.

The annual maximum benefit is usually about $2,000.
With an indemnity plan, employees generally have to pay their share of the cost of service up front. Some providers require payment of the full amount and the insurance company then reimburses the employee.

4. ACA Coverage

The Patient Protection and Affordable Care Act, also known as Obamacare, allows individuals to obtain dental coverage through the federal insurance marketplace as part of a health plan or as a standalone dental insurance plan. An additional benefit for parents is that pediatric dental services are included in the ACA’s essential health benefits. ACA plans can’t impose annual dollar limits, including for pediatric dental coverage. However, plans can limit the number of annual pediatric dental visits.

Picking the Right Plan

With these choices in mind, how do you pick the right one?

Employers considering adding dental insurance to their package of benefits might consider asking employees what their priorities and unmet dental care needs are before making that choice. For example, in a small town with only one or a few dental clinics, an HMO might make sense. In a larger city, where employees may commute long distances and want a dentist close to home, the PPO may be the preferred choice.

The bottom line is that dental insurance is the most popular voluntary benefit an employer can offer. The cost of providing this option can be well worth the benefit to the company in lower turnover and absenteeism, as well as higher engagement.

SOURCES:

  • Harvard Business Review, The Most Desirable Employee Benefits, February 15, 2017. https://hbr.org/2017/02/the-most-desirable-employee-benefits
  • National Association of Dental Plans, Who has dental benefits today, accessed April 9, 2018. http://www.nadp.org/Dental_Benefits_Basics/Dental_BB_1.aspx
  • Centers for Disease Control and Prevention, National Center for Health Statistics, Oral and Dental Health, May 3, 2017. https://www.cdc.gov/nchs/fastats/dental.htm
  • NerdWallet, Dental Insurance Benefits, Costs and Alternatives, October 7, 2016. https://www.nerdwallet.com/blog/health/dental-insurance/
  • WalletHub, 2018’s States with the Best & Worst Dental Health, February 1, 2018. https://wallethub.com/edu/states-with-best-worst-dental-health/31498/

Republished with permission from ColonialLife.