Insurance World

Even if you get insurance as part of a group you essentially enjoy the same benefits that an individual dental insurance plan provides with an added advantage. Because you are part of a group, you pay lower premiums.

Dental insurance carriers prefer to insure groups because the risk is spread around and more members in the group guarantee them additional business.
Many companies and unions offer this benefit to attract and keep good employees. The effect is very positive effect. This is to lighten the financial load of the employee by paying for a portion of their dental plan.

As a member of a group, your dental insurance plan is a result of a contract between your employer (or union), or plan sponsor, and a third party (insurance company). Any your concerns you have regarding your plan coverage should be directed to the plan sponsor or your employer.

To maximize the benefits found in your dental plan you should take time to know how it is designed and what its limitations are. A good group dental plan is one which covers around 60 to 80 percent of each dental treatment you undergo.

Some Features Common To Group Dental Insurance Plans

Direct Reimbursement program
Under this plan, the patient can go to their preferred dentist. After treatment patient is reimbursed a portion of the amount spent on dental care, regardless of whether the treatment is a minor or major procedure.

UCR or “Usual, Customary, and Reasonable” program
This design plan offers flexibility because the patient can go to their preferred dentist. The “reasonable” or “customary” fee limit is jointly determined by the plan purchaser and the third party payer.

Table or Schedule of Allowance programs
Each covered service is tabled and assigned a specific fee. The amount represents how much the plan pays for the services. Most times, plan does not pay for the entire treatment, and the patient has to pay for the difference.

Preferred Provider Organization (PPO) program
Contracting dentists give a discount on their service fees to attract patients. However, patients cannot avail of these discounts if they choose a dentist who is not part of this network.

Capitation program
The dentist signs a contract with the sponsor of the plan, and provides all or a specific number of treatments covered under the dental insurance program. In return, the dentist is paid a set fee for each patient or subscriber.

As a small business owner, you know the importance of being able to offer your employees health insurance. You also know the expense associated with it. What do small business owners do? How can they afford it? Well, depending on which state your business resides, there may be government help.

For instance, in the state of New York, Governor Pataki has proposed and Legislature has approved and enacted a program called Healthy NY. This program assists small business owners in providing health insurance for their employees.

Similarly, the state of Ohio, allows Group Purchasing Arrangements (GPA’s). This is where small and large employers may band together to purchase insurance plans and reap the benefit of lower premiums. Some are formed as a result of state legislation/regulation and others GPA’s a re formed by associations.

Kansas has the Kansas Health Partners Benefit Association. Their mission is to help reduce the number of uninsured in their state by helping small business so that they may be able to offer affordable health insurance to their employees.

A bill introduced on to the House of Representatives by Georgia Democratic Representative John Barrow. The purpose of the bill, H.R. 2073: Small Business Health Insurance Promotion Act of 2005 is to “…to provide tax subsidies to encourage small employers to offer affordable health coverage to their employees through qualified health pooling arrangements…”

This is a proposal before Congress. It would have to be passed by both the House and Senate and signed by the President before it is law. Get involved, contact your representative. Tell them to vote in favor of this proposal. After all, we elected them to do our bidding.

Bottom line, if you’re a small business, visit your state’s web site to see what legislation has been passed in your state. Additionally, check to see if there are program in existence that offer you help in providing health insurance for your employees.