Employers Sponsored Dental Care Insurance
In this time of downsizing, not only of jobs but also of employee benefits, there are still some enlightened employers in the United States who offer dental insurance coverage to their employees as conditions of employment. They do so for many reasons, but mostly to attract top-notch workers and to keep the ones they have.
Dental benefits are usually listed as a desirable employee benefit. Some simply recognise dental health as a factor in the employee's general health. Also a dental benefits plan makes economic sense since proper dental care eliminates a lot of employee absences or poor work performance since dental disease or discomfort are often indicated in both of these complaints. Time is money and time lost to the dentist should be prevented when possible.
Unlike medical conditions, which are often unpredictable, catastrophic, and costly most dental needs are predictable, preventable and, therefore, low risk. Dental disease is the most preventable of all disease, with the exception of accidental damage.
Employer sponsored dental plans are typically business arrangements between an insurance company and an employer. Most plans are designed to pay only a portion of the employee's dental expenses. Even when you and your dentist agree on the best treatment method for your condition, the contract provision of the dental plan may only pay a portion, or pay only for the least expensive alternative treatment (LEAT) as determined by the insurance company.
Employee sponsored dental insurance use the terms "usual, customary and reasonable" (UCR) to determine the portion of the dental treatment fee that will be paid. UCR reimbursement levels are determined by different methods and may vary a great deal among plans. This may result in the patient being required to pay the larger portion of the treatment costs. There are some important features to look for in an employer's sponsored dental insurance plan. Probably the most important is whether employees will be able to choose their own dentists and whether the type of treatment can be determined by the patient and the dentist.
It is also important to know if the plan covers diagnostic and preventive dental care or just emergency services? Also, the employee should know what type of routine dental care is covered and what form of major dental care is covered. Will the plan allow for referrals to specialists? If so, will the dentist be limited to a list of specialists from which to choose? Another feature to look for is whether the plan allows for referral to a specialist, if necessary and whether family members enjoy the same coverage as the primary insured employee.
by Sally.Anderson 19 years ago