Indemnity Dental Plans: Employee Benefits Broker

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 the above 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).

Traditional Indemnity Dental Plan Features:

• Choice of ANY dentist! (No networks or lists of dentists!).
• Preventive services covered 100% – No deductible.
• Only 20% participation needed.
• No employer contribution required.
• Claims paid direct to dentist or employee.
• Claims based on the 80th – 90th percentile of UCR.
• 800 customer service hot line.
• Low group rates.
• Pooled risk products.
• Two year rate guarantees.
• Top rated insurance carriers.

Preferred Provider Organizations (PPO)

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.

• Visiting a PPO provider will reduce treatment costs compared to a traditional plan.
• No balance billing above the covered amount.
• No referrals are needed to see a PPO dentist, even for specialty care.

Managed Care Dental Programs (DHMO)

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.

• No annual maximums
• No annual or lifetime deductibles
• Higher benefit levels than traditional plans
• Low out-of-pocket expenses compared to traditional plans

Freedom-of-Choice Programs

Broad Reach Benefits is a recognized industry leader in Voluntary Dental Programs. Based on years of feedback from employers and employees throughout the country, we designed a unique voluntary dental program. The program allows employees to receive dental care from either a traditional indemnity plan or a managed care program (the DHMO).

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 a 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 country. 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 Programs

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.