Types of Dental Plans

Marshall & Sterling Insurance can assist your company in evaluating the need for a dental plan for the company and selecting the right plan to fit the unique needs of the company and its employees.

There are numerous models of dental plans. In general, they can be divided into two categories: fee-for-service and managed care. Fee-for-service dental plans are typically freedom-of-choice arrangements under which a dentist is paid for each service rendered according to the fees established by the dentist. Managed care dental plans are cost containment systems that direct the utilization of health care by:

  • Restricting the type, level, and frequency of treatment;
  • Limiting access to care; and
  • Controlling the level of reimbursement for services.

In addition to covering employees, most dental plans cover spouses and dependents as well. Some dental plans require that new employees work a minimum amount of time, for example, six months before coverage begins.

Although the employer generally has the right to determine which employees will be covered, if the plan is self-funded, IRS rules limit the extent to which employees may be excluded because they are part time, or have not reached a certain age or worked for a minimum period of time.