Indemnity plans are by far the most popular and well-liked designs by employees and employers. Insured can visit any dentist nationally so there is never a question of whether the family dentist is “in the plan”. Additionally, dependents away at school, employees traveling and employees in companies with multiple locations always have access to dental care.
Ask any dentist which of these plan types they prefer and the answer is always the indemnity plan design. The key is to make certain the dental plan pays claims at a high level of reasonable and customary (80th - 90th percentile).
Adding a Preferred Provider Organization (PPO) to a traditional voluntary dental plan lets the insured choose a dentist from the nationwide network of participating dentists. Of course the insured can still receive care from any dentist they wish, whether they participate in the network or not. If the insured selects a PPO dentist they will receive care at discounted fees (typically 20%) and be assured of no balance billing above the negotiated fees.
Managed dental care plans are designed to offer employees and their dependents a broad range of services through a network of providers while helping to reduce dental care costs.
Each insured selects a personal dentist from the directory of participating dentists. Each covered member of the family may select a different dentist. Benefits may be significantly reduced if the insured uses a dentist who does not participate in the network.
Insured can actually switch back and forth between the indemnity plan and the managed care plan during the year by making a simple phone call to a toll free number. This change takes place without any intervention by the employers benefits department! This flexibility provides the insured with the ability to continue to use their own family dentist or utilize the services of DHMO provider for increased savings. The plan also incorporates a preferred provider network on the indemnity side for additional savings.
The program works especially well for groups of employees spread out across the coutnry. Access to a dentist will never be an issue since the insured can use the national DHMO network or simply choose the alternate program and use any dentist in the country.
Direct Reimbursement dental plans are self-funded by the employer. They provide complete flexibility in benefit design. These plans reimburse patients according to dollars spent on dental care, not the type of treatment received. Patients have the freedom to choose any dentist.