Dental Insurance

Group Dental Insurance coverage is a policy that is purchased by an employer and is offered to eligible employees, and often employee’s family members, as a benefit of working for that company.

There are three main methods for funding group dental insurance plans: fully insured plans, self insured plans, and a hybrid plan approach.

Fully Insured Plan
A traditional fully insured plan is a group dental plan under which the benefits are provided by the employer through the purchase of dental insurance coverage from an insurance company. In exchange for premium payments, the insurance company bears the full risk for the cost of the benefits provided.

Self Insured Plan
A self insured plan is a group dental plan under which the risk for the cost of the benefits provided is the responsibility of the employer. Typically, a self-insured plan will purchase stop-loss coverage to limit its financial liability to a certain level.

The employer often hires a third party administrator to perform such services as paying claims, collecting premiums or supplying other administrator services but the actual coverage benefits are funded by the employer.

Hybrid Plan
A hybrid plan is a way for your company to receive the financial benefits of a self insured plan along with the many upside benefits of a fully insured plan.

Types of Dental Insurance Plans:

DMO – Dental Health Maintenance Organization Plans
With a DMO members are required to choose one dentist or dental group to handle all their dental needs. A DMO will usually provide the most comprehensive level of benefits with the lowest cost to the insured. Routine checkups and other preventative dental treatments are either covered in full or require a small co-pay.

PPO – Preferred Provider Organization
A PPO dental insurance plan will provide members with more freedom to choose a dentist than a DMO plan. However a dentist from the network must still be chosen. With a PPO dental plan there is usually a deductible and a coinsurance amount.