Utah Dental Plan – Offering one makes economic sense to you as an employer.
- One reason for employee absences or poor work performance is dental problems.
- A Utah dental plan can help you find and keep good employees.
- In fact, Utah dental plans are one of the most requested employee benefits.
Utah dental plans are unique from medical insurance plans because most medical expenses are unpredictable, high cost and an insurable risk. Most dental needs and treatments on the other hand are predictable and low risk. Dental disease is most often preventable and treatment begins with relatively low-cost diagnostic procedures, such as exams and x-rays. If decay or disease is detected, the sooner it is treated, the less expensive that treatment will be. The dental needs of an employee group are highly predictable. Extremes in cost and utilization (evident in many medical benefits) are rarely observed with dental statistics
Utah dental plans are business arrangements between an insurance company and an employer.
Most plans are designed to pay only a portion of your dental expenses. However, dental plans may exclude or discourage certain treatments, such as dental sealants, which can prevent tooth decay and save you money later on. Carefully read a plan and know its limitations.
Some plans do not cover pre-existing conditions, such as missing teeth. Others may not cover dental implants, specialist referrals and other dental needs. Even when you and your dentist agree on the appropriate treatment for your condition, the contract provision of the dental plan may only pay a portion, or pay only for the LEAT (least expensive alternative treatment) as determined by the insurance company.
Another term you need to be familiar with is UCR (usual, customary and reasonable). Insurance companies use UCR to determine the portion of the dental treatment fee they will pay. UCR reimbursement levels are determined by the plan administrators. They may vary greatly between different plans — even when those plans are available in the same area. The fee the insurance company determines to be “customary” may be very low compared to the area’s average actual fee for the same services. The plans then generally pay a certain percentage of the UCR level which results in patient paying a greater portion of the treatment costs.
Benefits Manager can help you answer the following questions as you determine the best plan for you and your employees:
Ø Will your employees retain the freedom to choose their own dentists?
Ø Is the treatment determined by the patient and the dentist or by the insurance company’s payment policy?
Ø Does the plan cover diagnostic, preventive and emergency services?
Ø Will it cover preventive services such as sealants and fluoride treatments, which may save patients money over the long run?
Ø What type of routine dental care is covered?
Ø Does the plan cover crowns and bridges, braces, root canals, oral surgery and treatment of periodontal diseases?
Ø What major dental care is covered, i.e. cover dentures, implants or treatment for TMJ?
Ø Will the plan allow for referrals to specialists and will the dentist be limited to a list of specialists from which to choose?
Ø How does the plan provide for emergency treatment?
Partner with Benefits Manager today for help in correctly configuring this all important benefit for your employees.
