What do employees misunderstand about dental benefits?
Nearly 9 out of 10 workers say they would take better health, dental and vision benefits into consideration when choosing between a higher-paying job and a lower-paying job with better benefits.1 Your employees will value their coverage even more when you help them understand those benefits. Here’s how to educate your employees on their dental benefits so they don’t get stuck with an unexpected bill.
What is an effective date?
The effective date refers to the day an employee is eligible to start using your dental plan.2 For most employer-sponsored dental plans, the effective date is the first day of the month after the employee starts their job. Effective dates can vary by dental benefits provider and plan type. Make sure to inform employees that are new to the plan when they can begin using their dental benefits.
Dental coverage emphasizes preventive care. As a result, once your employees reach their effective dates, they can usually begin using their benefits to cover preventive services like exams and cleanings.
What is a waiting period?
After employees reach their effective date, they still may not be eligible to receive benefits for all dental treatments — especially more expensive care like crowns or dentures.3 Although it’s more common with individual plans,4 some employer-sponsored plans have a benefit waiting period. This is the amount of time before employees are eligible to use their full coverage.
For example, if your plan has a six-month waiting period for basic non-preventive services, such as a routine tooth extraction or a filling, it wouldn’t cover those services during that time. Some plans will waive the waiting period if the employee had dental coverage in the past 30 to 60 days.
As with effective dates, waiting periods can differ from plan to plan. Some employer-sponsored plans have no waiting periods. If your plan does have them, educate your employees that are new to the plan on any benefit waiting periods.
What if a procedure isn’t covered?5
If an employee needs major dental work, advise them to check their coverage. In addition to waiting periods, some dental plans may not cover select procedures such as teeth whitening or orthodontia. To ensure your employees aren’t surprised by their bill, advise them to ask their dentist for an estimate. They should also check with their dental plan provider to see what is covered before undergoing any major dental work. Even if the procedure is not covered due to a waiting period, it may be more costly to delay treatment if the problem worsens.
Visit our dental coverage basics page to easily help your employees understand dental insurance and maximize their dental benefits.
Sources:
1 https://hbr.org/2017/02/the-most-desirable-employee-benefits
2 https://www.deltadental.com/us/en/protect-my-smile/dental-benefits/library-of-terms.html
3 https://www.deltadental.com/us/en/protect-my-smile/dental-benefits/library-of-terms.html
4 https://www.investopedia.com/articles/personal-finance/122315/6-dental-insurance-plans-no-waiting-periods.asp
5 https://www.thebalance.com/dental-insurance-waiting-period-2645722
