Group Dental

Because dental expenses are more predictable than medical expenses -- seldom involving emergencies or catastrophic expenses -- the risk to employers in offering group dental coverage is significantly less than their exposure with group health coverage.






Do your competitors' employees have dental coverage?

Do your employees have dental coverage?

Should your employees have dental coverage?

Will dental coverage enrich your employee benefit plan?

What would the true cost be to implementing a dental plan?

Harman Stone Corp. can help!
Funding

Group dental coverage is offered via fully insured, partially self-insured, capitated and direct reimbursement plans.

A fully insured plan is underwritten by the insurance carrier or dental plan.  They assume the financial risk and the sponsoring employer only faces the risk of annual rate increases.

A partially self-insured plan allows the employer to assume some of the risk of the dental plan in return for the possibility of the reaping the rewards of good claims experience and plan performance.  In this instance, the plan is "partially" self-insured because the employer is insulated from "shock-claims" -- large claims that would be debilitating to the plan -- by "aggregate stop-loss' coverage."

Finally, a significant number of dental plans are offered on a capitated basis.  A capitated plan negotiates and contracts with dental providers ahead of time.  Providers are paid a flat fee per procedure -- the same fee all the other providers in the plan are paid.  This allows the plan to simplify their financial structure significantly.

The downside to a capitated plan inevitably is a much less than rich benefit structure.  However, for all of these reasons, these capitated plans are very attractive to small and medium sized businesses and employers.
Managing Claims Expense

A substantial number of employers are offering their dental plans, regardless of the funding arrangement, through a "managed care" mechanism:


However, the vast majority of DMO's are in California, Florida, Texas, Pennsylvania, and Illinois.


Types of Dental Benefits

Dental services fall into the following categories:









However, dental benefits are divided into three different levels: