Group Dental Coverage

Dental Coverage is a greatly appreciated Employee Benefit. Many companies do not offer Dental Insurance to their employees because it can be very expensive. What numerous employers do not realize is that many employees would pay for part if not all of the Dental premium.

After Health Insurance and a Retirement Plan, Dental Insurance is the Benefit most employees want.

We work with the top Regional and National Dental carriers to construct a plan to fit your needs.

We offer the following type of Dental Programs:

Indemnity- The traditional type of Dental Insurance. Participants can go to the Dentist of his or her choice. The coverage level will be the same no matter which Dentist your choose. The Insurance Company reimburses the provider a specified percentage of the Usual, Customary and Reasonable (UCR) fee for that particular procedure in your area. If your Dentist insists on charging a fee higher than the UCR fee, the difference is the responsibility of the patient. UCR fees vary by location. Here is an example:

You plan calls for Teeth Cleanings to be covered at 100% of UCR. The UCR fee for teeth cleanings in your area is $40.

Dentist #1 charges $40 for a cleaning. The Insurance Company would pay 100% of the bill up to $40 dollars. In this case your Insurance would cover the total bill.

Dentist #2 charges $49 for a cleaning. The Insurance Company would pay 100% of the bill up to $40 dollars. The patient would be responsible for $9 since the Dentist is charging an amount over the UCR fee. This is called Balance Billing.

Preferred Provider Organization (PPO)- The most flexible type of Managed Dental Care. You have a network of Dentists to choose from and you have the option to see a Dentist that is not part of the network. The coverage for Dentists in the Network is usually richer than the coverage for Dentists outside of the Network. Network Dentists have agreed to accept negotiated fees for every covered procedure, so in addition to having richer coverage at Network Dentists, there is no chance for Balance Billing. In addition, Claims forms are not needed at Network Dentists.

Going to a Non-Network Dentist under a PPO is the same as having Indemnity Dental coverage. The Insurance Company reimburses the provider a specified percentage of the Usual, Customary, and Reasonable (UCR) fee for that particular procedure in your area.

Dental Maintenance Organization (DMO)- Similar to a PPO with 2 distinct differences.

1. You must use a Dentist that participates in the Network. There is no coverage at Non-Network Dentists.
2. Typically you must designate a primary Dentist that will coordinate your Dental care.

Market Trends:

• With Dental costs rising, many employers are moving away from Indemnity Dental plans. PPO and DMO plans offer equal or superior coverage with lower premiums. PPO and DMO plans are able to contain costs better then Indemnity plans because of the discounts that carriers have negotiated with Network Dentists.
• Voluntary Dental plans are gaining market share. Many of our clients that do not have room in their Employee Benefits Budget to pay for Dental Insurance offer Voluntary Dental Plans to their employees.
• Management Carve-Outs are becoming more common. We work with many groups that either only offer coverage to the management team, or have a richer plan for the management team.

What Can The Guard Group Offer your Company:

In addition to representing all of the top Regional and National carriers, we are extremely proud of the plan design flexibility and creativity we have been able to provide our clients. Due Diligence in regards to rate stability is another area we are very proud of. While it is inevitable that Dental Rates will go up, we feel the carriers we work with have an extremely sound pricing structure. This is especially important in Voluntary Dental where loss ratios are expected to be higher. Getting the most for your Employee Benefits dollar is how we can help.

Let The Guard Group help you to enhance your Dental coverage.