We are
seeing more and more local companies make the switch from conventional
insurance plans to a self-funded, or direct reimbursement plan.
The wonderful thing about a direct reimbursement dental plan is the fact
that it is predictable. Unlike medical
insurance, dental policies have a maximum dollar amount of benefits that can be
paid out per person per benefit year, no matter what happens.
Self-funded
plans provide benefits to all three parties involved: the employer, the employee, and the dental
office. Employers save money when the
funds set aside for reimbursement are not completely used. Very few people use their maximum yearly
benefit. This remaining capital can be
used to fund benefits in future years, or even offer improved benefits. When a conventional insurance company is used
to administer these benefits, that remaining capital stays with them. If your employees aren’t using their benefits
to their fullest, you might be paying them way too much to administer your
plan.
Employees
benefit from direct reimbursements plans because they don’t have to worry about
their dentist being in network, or jumping through hoops to get their claims
covered. It’s simple, they choose their
dentist and can either pay for treatment themselves, and submit their receipt
for reimbursement, or the dental office can submit a claim for them. You can choose the way you want your plan to
function.
As far as
the dental office is concerned, we receive payment much faster without claim
issues, or denials that we regularly receive from insurance carriers. This allows patients easier access to
treatment. The last thing we want is for confusing insurance
rules and regulations to discourage patients from getting treatment.
There are
several ways to structure your self-funded plan, you can choose which ever
benefits or limitations you want to include.
It’s all up to you!
For more
information, check out the American Dental Association website: http://www.ada.org/en/public-programs/dental-benefit-information-for-employers/direct-reimbursement-plan/how-direct-reimbursement-works.
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