Group Dental Insurance

Find the Best Group Dental Insurance for Your Client

Group dental insurance is an excellent way for employers to provide an affordable dental care option for their employees. Studies have shown that taking care of one’s dental health with regular check-ups and cleanings is beneficial to overall health and wellness. Having dental insurance is vital in helping with out-of-pocket costs, especially when a major procedure is needed. 

Offering group dental to your clients is a great way to increase your retention rates and build relationships with new clients. By providing more product options to your clients, they are encouraged to continue to return to you as a reliable and trusted source for their coverage needs. 

What is group dental insurance?

Group dental insurance is an employer-sponsored dental policy that is optional for employees to enroll in. In other words, a business or other employer purchases a dental insurance policy and offers coverage under the policy to employees. Employees often enroll in a group dental policy because it is both affordable and useful. While employers are not required to offer group dental, it is a great way to enhance their benefits portfolio and promote employee retention. 

In order to qualify for group dental insurance, a business needs to have two eligible full-time W2 employees or two owners. Unlike group health insurance, employers are not required to contribute to group dental. The cost to employees varies based on how much the employer contributes. Some employers may pay for a policy in its entirety, while others will have employees pay for 100% of it since it can be a voluntary product. If you are self-employed and are not qualified for group dental, it is best to shop the market or work with a broker to find the best solution for your needs.

One of the disadvantages of group dental is that waiting periods, which can be as long as two years, can affect individuals in urgent need of dental care. However, some carriers offer group dental plans with no waiting period. On the other hand, plans with waiting period requirements tend to have lower premiums. It is essential to consider these waiting periods when looking into products and the annual maximum benefit they offer.

What does group dental typically cover?

Group dental insurance typically provides preventative care at no cost, including two annual teeth cleanings and x-rays. There are also three different classes of coverage with varying benefits and cost structures. The annual maximum benefit applies to all three tiers, and most—but not all—dental plans have a 100/80/50 coverage structure.

  • Class 1 dental insurance provides preventative and diagnostic care such as cleanings and x-rays. Services in this class are covered at 100%, up to two visits.
  • Class 2 dental insurance provides basic restorative care, including fillings and some repairs to crowns and bridges. Services in this class are covered at 80% beginning after your deductible is met.
  • Class 3 dental insurance provides coverage for major restorative procedures, such as implants, crowns, and root canals. Services in this class are covered at 50% after your deductible is met and the waiting period is past.

What does group dental typically not cover?

Group dental insurance cannot be used outside of the United States. It does not cover treatments done for cosmetic purposes, including corrections of congenital mouth formations such as a cleft palate, unless determined to be a medically necessary procedure. Some plans may offer coverage for orthodontic procedures, but not all do. It is important to note that items not covered by Medicare Part B will not be covered by an individual dental policy either.

How is it different from other dental policies?

A group dental plan differs from an individual dental plan because it is purchased by an employer instead of by the individual. The differences between group dental and individual dental will not be as pronounced as they would be with health insurance. If your client wants higher benefit amounts than either plan would offer alone, they can get both individual and group dental coverage. Some plans do not coordinate benefits, and some clients want higher benefit amounts, in which case they would get both individual & group dental.

Frequently asked questions about group dental insurance.

Why do group dental policies have waiting periods?

Group dental plans typically have waiting periods to ensure the individual’s responsibility to the plan. For example, it prevents someone from paying a $30 premium for one month to cover a $5,000 procedure.

Are there group dental plans that waive the waiting period?

Most providers will offer plans with and without waiting periods.Plans with waiting periods tend to have lower premiums

Can group dental be used with any dentist?

The eligible network and dentists covered depends on whether the plan is an HMO or PPO. Preventative care is typically included in both options at 100%.

  • HMO: You will need a primary dentist for an HMO. These are generally a smaller network of doctors and have a flat fee for non-preventative care.
  • PPO: You can generally see any dentist of your choice. These have a more extensive network of doctors, and individuals must meet the deductible for non-preventative care.

How much does group dental cost, and what will be offered to me?

This depends on the plan and what the annual maximum benefit is. There is no one size fits all plan. As an example, if a plan has a $3,000 annual maximum, then that is the most it will cover your dental expenses for the year. Therefore, it is important to review the details of your plan to determine what your annual maximum benefit amount is.

Is there a deductible? 

Yes, there is typically a deductible, once that is met your insurance would begin coverage.

How do I select the best group dental insurance for my client?

In general, the plan with your client’s network and preferred dentist will be the best option assuming that the other features of the plan meet their needs. However, with group dental, you should also consider the plans from the employer’s perspective. Most employers prefer to be billed for services at once, so while some of your clients may reach out to you looking for dental care, you should also reach out to those looking into other policies as well. 

Work with your clients to see if you can formulate a solution that bundles their policies together. For example, if you can find a provider that also offers medical insurance and vision plans, that may sway your client towards those policies. Be sure to communicate the urgent details of the plan, such as waiting periods and deductibles. Do not make a decision based solely on price because the cost is not always indicative of the services provided or if it will be a good fit for your client.

Should I buy group dental insurance through a broker?

While you can technically go directly to the insurance provider, you may find some difficulty doing so. When working with a carrier on your own, you will have to reach out to them directly if you need assistance or account maintenance, which can be a long and tedious process. You may also find it more difficult to compare policies between different providers given the many options available. 

A brokerage agency has access to multiple carriers and will do the shopping for you. They can help you to work through the policy details that each carrier is offering in order to find the best fit for your client. Because insurance carriers compensate brokerage general agencies (BGAs) for helping clients find and access their policies, brokerages can help you shop the market at no cost to you. 

How do I find the best group dental insurance brokerage general agency?

There are several ways to find dental insurance brokers. You can also connect with NAILBA, a leading insurance industry organization promoting consumer choice.

You can also do your research by prospecting several insurance brokerages in your area. We recommend looking for these qualities in a broker:

  • Responsiveness and attentiveness. Are they knowledgeable of products and solutions available to serve you and your clients’ needs?
  • Back-office support. What happens after an application is submitted?
  • A good team instead of just a good salesperson: Make sure that the service is as good as the pitch. Service can make or break a relationship.

You can also learn a lot about the brokerage general agency by calling them and asking pertinent questions, such as:

  • How long have you sold dental insurance?
  • Have you had any complaints with the state?
  • Who are your primary carriers? What are the carrier ratings?

Most importantly, visit the agency. Do an onsite visit and speak with the brokers in person.

EMG can help.

At EMG, we are here for you. Our team of group dental insurance experts are devoted to providing you with consistent support. With a dedicated group dental department, our team is able to provide both front-end support and back-end support to all of our clients.

In addition, as a brokerage general agency, we can offer the best carriers to our agents and help you easily compare the products to determine what is best for your client. EMG is a one-stop shop for anything from enrollment to account maintenance, and our goal is to help you save time and make the right decision for your clients.

Connect with us by phone, online, or in-person, or schedule a consultation with your sales director on how to grow your business today.

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