Group Dental Benefit Plans

Understandably, many benefit managers fail to realize that dental risk is vastly different from medical risk. Unlike medical risk, dental risk is highly predictable and is completely free of catastrophic loss. In addition, dental expense, unlike medical expense, experiences stable inflation. Estimating finding costs, therefore, can be done with a high degree of confidence.

Dental Utilization
Experience with hundreds of Direct Reimbursement plans already implemented indicate that employers can expect about 60% of employees to utilize the benefits. With Direct Reimbursement, employers pay only for those employees who do utilize the plan rather than paying insurance premiums for all employees.

Direct Reimbursement more flexible than traditional dental coverage!

Direct Reimbursement enables an employer to determine coverage based on what management and employees wish to spend. Plan payments typically range from 50% to 100% of costs. Annual maximum benefits may range from $500 to $1,500 and up. If there is an existing dental plan, the benefit levels in that plan can be duplicated. Instead of complex fee schedules, the benefits need only be stated in terms of dollars spent.

• It can save money by lowering the cost of benefits and reducing administration expense.
• The employer retains total flexibility and control.
  Small as well as large companies, with or without an existing self-insured medical plans, can utilize Direct Reimbursement.
• Simplicity is ensured.
• Funds budgeted to pay claims stay with the employer and can earn interest.
• The employee identifies with the employer as the benefits provider rather than an insurance company, thus morale improves.
• Co-payment factors and maximum annual ceilings help control costs and limit employer annual risk; thus, plan cost increases can be eliminated or, at the very least, minimized.
• The plan is extremely cost-effective compared to traditional insurance dental programs and even cost-effective with advantages for plans that are presently self-funded.

• It’s easy to understand and they know the amount of reimbursement they’ll receive before visiting the dentist.
• They need only provide proof of payment and a simple statement from the dentist to get reimbursed. No complex claim forms. If a credit card is utilized for payment, the employee is usually reimbursed prior to receipt of the credit card billing.
• It offers them the freedom to select the dentist of their choice.
• There are typically no exclusions, restrictions or pre-existing conditions.
• There are no pre-authorization requests from insurance companies.
• A greater portion of dental care dollars goes to actual treatment.
• It has enriched benefits, it’s simple and it’s hassle-free.

• Plan costs are based on actual dental expenses incurred, not on premium payments by employer/participant regardless of use of service.
• Administrative overhead costs typically are reduced-it’s simple and cost-effective.
• Flexible plan design may include deductible, co-payments and an annual maximum benefit.
• Plan is easy to implement at any time of the year.
• Employer and employees find plan easy to understand and easy to use.
• Eliminates waiting periods, as well as exclusions and limitations.
• The freedom to use dentist of choice is ensured.
• Fosters efficient consumer-driven dental care planning.
• Employer dollars stay at home and can earn interest.
• Dentists in the community will appreciate and support Direct Reimbursement.

• The Benefits Administration, Inc. is endorsed by the Virginia Dental Association with 4,000 members. The American Association of Orthodontist with 18,935 members worldwide.
• Benefits Administration, Inc. has been promoting Direct Reimbursement Dental Plans since 1978.
• We have over 100 Direct Reimbursement clients nationwide.
• For a single administrative fee per employee, per month Benefits Administration, Inc. will provide:
• Prompt and accurate dental claim settlement.
• Plastic ID cards provided.
• Employee Benefit Summary Booklets.
• Claim Forms.
• Summary Plan Descriptions.
• Toll Free 800 Customer Service Number.
• FAX number for claim form submission.
• Web based enrollment and client plan administration.
• Benefits Administration, Inc. staff offers over 18 years of Dental Benefit Administration and service experience.