Group Dental Service

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

Dental Service

Dental service 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. 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.

A good group dental service plan is one which covers around 60 to 80 percent of each dental treatment you undergo.

Some Features Common To Group Dental Service 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

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. 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 service program. In return, the dentist is paid a set fee for each patient or subscriber.

You may want to check out Dental Health Plans information here.