Hybrids Can Boost Dental Benefit Performance

Employee benefits such as dental insurance did not get much attention during the health care reform debate, even though some consumers have difficulty affording them. In fact, one in four Americans under 65 lacks dental insurance, according to the National Center for Health Statistics.

It is not just employees who have difficulty paying for the coverage. Many employers are still struggling in this economy and need to trim expenses wherever possible. In some cases, rather than dropping the coverage, companies will offer voluntary benefits. That means employees pay all the costs but get lower rates through a group plan.

Another option that reduces costs for employers is the discount dental plan. Such plans feature a negotiated discounted rate for typical services such as dental exams, fillings, crowns, root canals and cleanings with participating dentists. Discount dental plans allow savings in the range of 10 percent to 60 percent. Discounts for specialty care such as orthodontia or cosmetic dental procedures range from 15 percent to 20 percent.

That helps employees keep benefits, but total costs still fall to workers. Some employers that want to provide coverage and cut costs can split the difference with a hybrid plan. Hybrid dental plans combine the advantages of a discount plan with the flexibility of a traditional plan. Discounts are extended to members who receive care from an in-network dental provider at negotiated fees once insured benefits have been exhausted, or for adult orthodontia or cosmetic care, which may not be covered by the insured portion. The discount dental plan provides access to care at a reduced fee.

Premiums are often half the cost of a typical insured plan. In addition, the insurance company may not find it necessary to impose the typical annual plan maximum benefit of $1,000 to $2,000.

The legal and tax information contained in these articles is merely a summary of our understanding and interpretation of some current provisions of tax law and is not exhaustive. Consult your legal or tax advisor for advice concerning your particular circumstances.


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