Navigating Benefits

Explaining Dental Insurance Terminology in a Way Your Employees Will Understand

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Posted by May 3, 2017

If you’re going to invest in a company dental plan, you’ll want your employees to make the most of the benefits. For this to happen, your employees need to understand their coverage. The dental insurance terminology in official plan documents can be confusing and may be so intimidating that employees decide not to use the plan. But regular dental care is essential to both oral health and overall wellness.

To encourage your employees to use their dental benefits, take the time to talk them through the key points of your policy in layman’s terms. Here’s how.

Dental Benefits

The best way to get employees interested in your dental plan is by letting them know what it covers. This way they can visualize the benefits. Most plans offer different categories of benefits. For example, a plan may cover 100 percent of preventive care, such as cleanings and X-rays, 80 percent of routine care, such as fillings, and 50 percent of more substantial care, such as braces.

Regularly send emails to your employees reminding them about these benefits, and also point out that they expire each year. For example, if a plan includes a free annual cleaning, you should send out a reminder email in November encouraging employees to take advantage of that benefit before the end of the year.

Your reminder is a good chance to explain the benefits of regular dental care so that employees will be even more motivated. Seeing the dentist not only helps keep your mouth healthy, but may also reduce your risk of heart disease and stroke, according to the American Academy of Periodontology.

Exclusions

It’s also important for employees to know what isn’t covered by your plan, known as exclusions. For example, some plans do not cover preexisting dental problems that an employee had before they received insurance, such as a missing tooth. Plans may also have a waiting period before coverage kicks in for new employees. This means newly hired employees need to work a set amount of time before they’re covered.

Let new employees know about all exclusions when they join your company so they will not run into any surprises when they go in for treatment.

Costs For Employees

Even with dental insurance, your employees will still need to pay some money out of pocket for care and should understand the various costs in the plan.

Deductible: The up-front fee an employee will need to pay before the insurance kicks in and covers any remaining costs.

Copayment: The percentage that an employee will need to pay out of pocket for treatment. For example, if a plan covers 80 percent of routine dental work, the employee will need to pay the remaining 20 percent of the bill.

Annual Limit: Plans can have an annual limit for coverage, which is the maximum amount the insurance company will pay in a given year. If an employee gets dental work once this limit has been reached, they will need to pay for it themselves.

A good way to teach employees about your plan’s costs is by giving them examples. Think of some common dental needs, such as filling a cavity or getting a child braces, and run the numbers for each treatment to show how much it would end up costing them out of pocket under your plan.

Networks

If your dental insurance policy uses a dentist network, you will need to explain what this means to your employees. Pay attention to whether your plan is using a PPO (Preferred Provider Organization) or a DHMO (Dental Health Maintenance Organization). In a PPO, employees can still see non-network dentists, but they have to pay more out of pocket. With a DHMO, employees have to stay in the network to receive any dental benefits. Always explain to new employees how the network works, and be sure to update your workforce if you ever change to a new dental network.

While understanding dental insurance terminology is not difficult, your employees may need some help navigating their dental benefits. Regular dental care is not only crucial to maintaining good oral health, but can also significantly reduce other health care costs. By keeping your employees fully informed and regularly reminding them about their dental benefits, your entire workforce will get more out of your dental plan.

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