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An Overview of Self-Funded Dental Plans

Many employers recognize that dental benefits are important to their employees for a variety of reasons.

In most cases, this means purchasing fully funded benefit plans. In other cases, employers provide their own self-funded benefits, but have a third party manage their claims through Administrative Services Only (ASO) agreements.

WHAT ARE SELF-FUNDED DENTAL PLANS?

A self-funded or self-insured dental plan is where the employer assumes the financial risk of providing benefits and pays claims as they occur instead of purchasing coverage from an insurance company. Purchasing coverage from an insurance company is called a fully-insured plan. In both types of plans, the employee usually contributes to the benefit plan.

WHAT DOES DELTA DENTAL DO FOR SELF-FUNDED PLANS?

When a company with a self-funded plan works with Delta Dental through an ASO agreement, it means the company can still use our expertise to help provide dental benefits to employees.

Our self-funded groups have access to Delta Dental’s large network of participating dentists (98% of dentists in South Dakota) and the fees we’ve negotiated to pay claims, and can use our claims review and payment processes. We’ll also help ensure HIPAA and other regulatory compliance.

WHY DO COMPANIES CHOOSE A SELF-FUNDED PLAN?

Self-funded plans can save companies some costs such as insurance premium taxes and risk fees associated with a fully-funded plan from an insurance company. Self-funded plans also only pay for actual claims instead of paying a premium to cover an employee whether or not the employee visits a dentist.

It is usually large employers who use self-funded dental plans for various financial reasons. But remember, self-funded plans also assume the financial risk of all claims. It’s best to visit with an insurance broker or consultant on your options.

WE CAN HELP!

We’d be happy to visit about the fully funded and self-funded options for a dental plan to fit your company’s needs. Call us toll free at 1-800-627-3961!