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5 Ways to Help Employees Become Better Dental Consumers

If employees don’t understand their dental benefits, they may pay unexpectedly out of pocket for their expenses. Worse, they could be vulnerable to fraudulent dental claims that contribute to rising insurance premiums. And with recent statistics showing insurance companies were paying at least $7 billion for Canadians’ dental care annually, employers have an interest in helping their staff become better dental consumers.

About 65% to 75% of employees use their dental benefits each year, with 6 procedures over the course of 2 annual visits on average.  A typical visit is a recall exam that includes the dental trifecta of an oral exam, scaling and polishingental benefits each year.  Most of these procedures are diagnostic and preventative, but overcharging, fraud and plan abuse does happen.

Here are some ways employers can help employees become better dental consumers:

  1. Refer to carriers and other experts: employers should first direct employees to plan booklets that outline coverage and reimbursement levels. Many insurers have plan details readily available online, and members can sign in to see if they’re eligible for a procedure, at what percentage and when.
  2. Identify communication opportunities: use plan or carrier changes as opportunities to communicate with employees.  This could include conducting focus groups to determine which benefits employees want most, allowing them to be part of the planning process and in turn become champions of the plan.
  3. Leverage the plan: employers can use plan design to motivate employees to educate themselves.  For example,a 20% co-payment will ensure employees look at their invoice and question their dentist.
  4. Ensure employees know their responsibilities: employees shouldn’t rely on dentists to know their coverage, and should instead submit requests for predetermination if they’re unsure whether the plan covers a procedure. Employers should tell employees never to sign blank forms for their providers, which could result in added charges.
  5. Make a statement: employers can prepare and distribute an annual total rewards statement that documents salary, vacation, pension and benefits, all in dollar amounts. When employers share the costs and usage of the benefits program with employees, it helps them see the bigger picture and become more invested.

Source: Understanding the Costs of Dental Benefits by Michelle Schriver, Benefits Canada (February 22, 2016).

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