Types of dental insurance plans for employees

Direct reimbursement plan
This plan works on the amount that the company set aside specially for this purpose. In this plan the employees are reimbursed the money that they have spent for dental care. The most positive aspect of this pan is that it is straight forward and not involves any complex calculations. This plan is widely recommended by American Dental Association. Direct reimbursement plan is considered as most expensive for the employers. Certain small business finds it difficult to go in tune with this plan because of the cost factor involved.

Indemnity plans
These plans are more feasible. Under this plan the amount of premium is paid to the insurance company and the company in turn pays the amount to the dentists for their treatment. Under this plan the insurance company generally uses UCR (usual, customary, and reasonable) for making payment to dentists. In case if the UCR rate used to pay dentists falls short of dentist’s rate, the patient has to make up the shortfall. The insurance coverage under this plan are 100% for preventive measures like cleanings, 80% for basic work like a crown or cap, and 50% for major procedures like oral surgery.


Managed care plans
These plans are treated as the least expensive. These plans include some cost control measures and are best suited for small business. This plan wants the patients to pay a certain amount as co-payment and the co-payments vary according to the procedure. Preventive procedures are normally performed without a co-payment and advanced procedures are carried out with a higher co-payment.

The managed care programs are of two types, they are:

a. Preferred Provider Organization (PRO) Program
Preferred provider organization program consists of a network of dentists. The dentists who fall under this plan have reduced their charges with a view to participate in this plan. The employees can select the dentist from this pool, if the employees have to go to a dentist not in this pool they have to pay penalties.

b. Dental Health Maintenance Organization (DHMO) Plan
In this plan also the employees have the right to choose the dentist from the pool, but in this plan instead of discounting the fees the dentists provide certain treatments free of cost. The dentists are paid a fixed amount as fees per individual even if the patient never ever receives the payment.

The above stated are the various plans of dental insurance provided by the employer to the employees. It is possible for the employees to select the best suited plan after analyzing the advantages and disadvantages of the available options. By selecting a proper dental insurance it is possible for the employees to assure the health and safety of their teeth.

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