Why Dental Insurance is a Critical Component in your Wellness PlanMay 3, 2017
House Passes AHCA Bill: The 4 Changes That Could Be in Store for School, City and County EmployersMay 5, 2017
In our previous article, we discussed Why Dental Insurance is a Critical Component in your Wellness Plan. Whether you are looking to switch providers or implement a new plan, here are five smart dental insurance shopping tips.
- Dental Network: Check to make sure that the provider’s dental network has sufficient in-network coverage in your area. If an employee visits an in-network dentist they receive discount rates on services. Some rural schools, cities and counties may find that dental networks in their area are sparse. If this applies to your organization, check with your NIS Representative. There are other ways to set up a plan without a network.
- Tiered Plan: Instead of charging everyone one price for a dental plan, employers may prefer to offer a tiered plan. This allows employees to select a plan that fits their needs, whether that be employee coverage, employee + 1 (spouse or dependent) or family coverage. Rates are different per tier.
- Orthodontics: Do you want to include orthodontics in your dental plan? If yes, do you want all employees to share in the cost or only charge those that will use it? Including this benefit in your plan will add an additional cost to your premium. Some employers offer orthodontics within a tiered plan, where only select tiers include orthodontics (and pay for the benefit). Other employers may elect not to include this benefit thinking that employees could use their Flexible Spending Account or HRA funds to covers these costs.
- Waiting Period: Some dental plans have a 6 or 12 month waiting period for certain dental procedures like a root canal. A waiting period is the amount of time that must pass before you are eligible for certain benefits. If you are switching from one group plan to another, check to see if the provider will waive the waiting period or if it is enforced.
- Rollover: If you are considering switching carriers during the plan year, what happens to employees’ unused funds that are left over from their annual maximum? Some providers honor a rollover, where employees’ unused funds can be rolled over and added to their annual amount. Other providers may limit the amount that can be rolled over, and others do not honor a rollover whereby any unused funds will be forfeited.
It’s a good idea to review your utilization reports before changing carriers to see the funds employees have leftover and if the provider honors some type of rollover. If your employees have a large amount of unused funds and rolling over amounts isn’t an option, you may decide to wait to change carriers.
Contact your NIS Representative if you have any questions regarding dental insurance.