Group Dental Insurance

Group dental insurance is an important part of the benefit package provided by an employer.

An attractive dental insurance plan is an essential incentive for employees to accept a position within your firm.

As an employer, you want to provide your employees with a dental plan that covers not only routine care, but reduces costs out-of-pocket.

What Can Group Dental Insurance Cover?

Typically a group dental plan is a group insurance policy or rider which will cover teeth cleanings and routine oral examinations for the insured.

However, there are a variety of coverage levels for other procedures included within the plan, such as:

  • X-Rays
  • Root Canals
  • Crowns
  • Bridges
  • Dentures
  • Periodontics
  • Endodontics

Make sure to read over all the fine print regarding the coverage of a dental plan. Certain procedures, such as oral surgery, might entail an additional out-of-pocket cost.

There are three primary areas regarding group dental insurance plans:

  1. preventative
  2. minor
  3. major

Preventative dental is coverage for things like x-rays and teeth cleanings. Usually if these services are provided by in-network providers they are covered 100%. Yet, there could be a slight co-pay. It is suggested to choose in-network providers with an HMO plan; PPO plans are more costly for providers out of network.

The majority of dental plans cover 60-70% of the costs for minor dental services—extractions and fillings—provided in-network. In addition, there could be a waiting period of up to six months (length of time on the plan) before coverage begins.

Coverage for major dental services like root planing and root canals typically have 50% coverage when in-network. The waiting period is typically a year with an indemnity or PPO plan.

What Does Group Dental Insurance Not Cover?

Group dental insurance plans usually do not offer coverage for any pre-existing conditions prior to plan enrollment. This is up to and including any teeth which might be missing.

Your group dental insurance might also include an exclusion clause within the policy. An exclusion clause permits the insurer to decline to cover any injury to the teeth that resulted from certain acts. A particular case would be broken or missing teeth occurring while committing an illegal act.

Are There Policy Limits?

How often you are allowed to receive a particular treatment might be one of the limits set by your dental policy.

However, in order to preserve one’s oral health, treatment might be required more often.

An example might be gum therapy or dental wellness examinations. These are sometimes needed every six months, but sometimes a dental provider recommends it be done quarterly.