Posted April 8, 2014
Some surprises are pleasant, like finding a $20 dollar bill. But when it comes to things we value and count on, such as dental insurance, most of us don’t like surprises. No one wants to visit the dentist, only to find out later the services are not covered by their insurance plan. Here are numbers six through 10 of our tips for evaluating dental plan and coverage options to help you avoid surprises with your benefits. Review Part 1 for the first five tips.
6. Network access – If the plan design includes a dental network, determine whether there are enough contracted providers in areas where employees need them. Ask carriers how they count the network providers, including access points and locations. Also find out how the carrier verifies the dental providers’ credentials.
7. In-network and out-of-network providers – Know the coverage allowance for services provided by in- and out-of-network dental providers. For in-network providers, not all 90th percentiles are created equal. The 80th percentile for one carrier may equal the 90th for another. Ask carriers for the source of their data and how often they update their records.
8. Rewards and incentives – Dental insurance has come a long way over the years. Current plans offer many innovative features, such as carry-over maximums, sharing dollar maximums within the family and not counting preventive procedures toward the maximum benefit amount. Some plans also include other benefits, such as vision and hearing coverage or prescription and eyewear discounts. Know what extra incentives are built into the plans that increase their value.
9. Premiums and persistency – Some dental carriers have dedicated administration systems for dental plans, and they know how to price the plans accurately; others adjust rates each year to cover unanticipated costs. Seek out information about customer satisfaction with coverage and service, and ask about the percentage of customers who renew their plans.
10. Carrier expertise – All dental carriers are not the same, so assess the differences carefully. Look for carriers whose top priority is dental. Find out their reputation for claims processing and customer service.
To learn more, download the white paper, 10 tips for reviewing dental plans.
Read how adult and pediatric dental (and vision) benefits fit within the ACA.