Universal Benefit Plans Blog

Health and dental insurance plans are standard offerings in employee benefit packages, and have been so for a long time. And since cost control is such a major buzz word of late, insurers have developed a whole host of creative plan options that help subscribers spend benefit dollars more efficiently.

But just like the latest fashion trends, new trends in the health and dental plans arena are not “one size fits all”. Different options provide different organizations flexible ways to design plans that best meet both individual and group objectives. Here are a few emerging options in the dental plans arena.

#1 Diagnostic and preventative (D&P) care not applied to annual max.

We all know that insurance dollars spent on preventative care can save hundreds of thousands of dollars in the long run and enhance the overall health of your employees too. Large bodies of research have shown that teeth cleanings and x-rays can reduce individuals’ risk of tooth decay and gum disease as well as pinpoint serious health issues such as hypertension and diabetes.

In light of the above, many insurers have created measures such as a D&P Max Waiver—which allows employees’ diagnostic and preventative dentistry expenses not to be applied to the annual maximum.  This enables maximum benefit dollars to go farther in paying for costly restorative procedures (i.e. root canals, crowns, etc.). Additionally, many plans provide coverage for additional D&P services to individuals with chronic conditions such as diabetes and heart disease that necessitate more aggressive preventative dental care.

#2 Hybrid plans triggered by consumer driven health care

We’ve all witnessed, and so many of us have made, the move to consumer-driven deductible health plans coupled with tax advantaged plans that defray employee out-of-pocket costs. These hybrid plan designs help employers reduce premium costs and reap long-term savings through increased consumer accountability.

When companies elect consumer-driven health plans, they willingly accept a certain amount of financial risk to save on premiums. Having a discount savings card as part of your program can reduce your group’s exposure and many cards include discounts on a variety of services (such as dental).

#3 Creative new ways to extend maximums

Many of us remember the recent cell phone commercial where a mom scolds her husband and children for “throwing away” their rollover minutes. This commercial was based on the principle that minutes family members didn’t use one month were still good in the next because they rolled over.

Many dental plans now have a similar provision called annual maximum rollover. This allows subscribers to apply up to a certain amount of their unused annual maximum dollars to the next plan year’s annual maximum amount.

Many dental plans also include emergency reserves, which allow subscribers to borrow from future annual maximum amounts and use the money to fund current expenses.

#4 Shared family maximums

Just like with the rollover minutes, we’ve also seen cell phone commercials for plans where family members can share minutes. Now some dental insurance plans come with this feature too. With shared family maximums, the family unit shares one “family size” maximum benefit each year as opposed to each member having an “individual size” amount.

This practice accommodates the simple truth that not all family members use their dental benefits equally. One family member may need to have a lot of work done one year another may just go for their cleanings and exams. If that’s the case, why not allow the lower user to share unused benefit dollars with the higher one? If your plan has shared family maximums, you definitely can.