What plan limitation are employers using to involve the employee in the cost of dental care?
Some of the most common benefit plan designs currently being offered are: • Annual deductible amounts In this case, the employee may be required to pay the first $25 or $50 claimed every year. • Frequency limitations Dental plans may limit the number of visits to the dentist each year that will be covered by the insurance plan. • Annual dollar maximums Employers may create a maximum limit (e.g., $1, 500) that the dental plan will cover each year. • Co-payment (or co-insurance) Through a sharing formula specified in the dental plan contract, the dental plan may only cover a percentage of the eligible amount claimed. The employee is responsible for paying the remainder. When are co-payments used? Co-payments are sometimes applied to diagnostic, preventative and basic services, but they are more frequently applied to comprehensive or extensive services such as endodontics, periodontics, prosthodontics and orthodontics. Sometimes your plan will cover 80% of the bill leaving you to pay the
