Advantages of Offering a Dental Benefits Plan to Employees (Part 3 of 3)

employee dental planKinds of Dental Insurance Plans

Managed Care Dental Plans

Preferred Provider Organization (PPO) plans are plans in which the patient has to select a dentist from a list provided to him. These dentists have agreed to discount their fee by contract with the insurance company. Some PPO plans also allow patients treated by dentists outside their list, where the patient is penalized by excess co-payments and higher deductibles. PPO’s are normally less expensive than indemnity plans in their class.

Keep the following in mind while reviewing a PPO Dental Insurance Plan.

What is the percentage of the premium used for administration?

Will the discount influence patients to change their regular dentist? Will the amount of the discount the dentist ahs to offer affect the number of treatment options for the patient?

What is the liability of the employer in the event of the plan influencing dentist selection or treatment?

What are the criteria of selection of dentists for the plan? Does it have adequate number of dentists under contract? What is the geographic distribution of dentists? Does the PPO dental insurance plan provide for specialist referrals? If so, are the dentists limited to a specialist on the “list” only?

How does the plan provide for emergency treatment? If so then how does the plan provide for emergencies outside the geographical area?

Dental Health Maintenance Organization (DHMO) or Capitation plans are designed in such a way that the patient does not have any financial payout when he goes for treatment. These plans pay the dentists on their “list” a fixed amount of money monthly per enrolled family or individual, regardless of visits. In return, the dentists provides specific types of treatment to the patients who visit him at no charge, any other types of treatments require co-payment. This way, the DHMO is rewarding dentists to keep patients in good health, thereby keeping the costs low. This kind of plan is one of the least expensive.

Factors to consider while reviewing a DHMO plan.

 What is the percentage of the premium used for administration?

Does the employer have access to enough information for him to determine the level and amount of treatment rendered to each of the employees?

What is the utilization percentage for patients in this plan? Average waiting period for an initial appointment and average period between appointments has to be given due consideration.

What is the dentist/patient ratio for the DHMO plan? What is the criterion of dentist selection in the program? What is the geographic distribution of dentists?

What percentage of dentists is selected for from those who applied to participate? How many dentists withdrew from the program in the recent past?

What is the rate of compensation for the dentists? Is it sufficient compensation for the needs of the covered patient population? What are the provisions made for dentists in the event of unforeseen utilization?

What are the benefits for patients needing a specialist’s care? How are specialists selected and compensated? Does the plan have adequate specialists?

Does the program provide for any emergency treatment? If so, is it available outside the geographical area?

 Fee-for-Service Dental Plans

Direct Reimbursement (DR) plan is a self-funded dental insurance benefit plan which reimburses patients on actual spent on dental care. It is not based on the type of treatment received. The patient has complete freedom in choosing the dentist. The employers are liable to pay a percentage of actual treatment cost, but they do not have to pay monthly premiums for employees who do not need the benefit. Moreover the employer is free of any responsibility to take decisions on mode of treatment due to previous plan selection or sponsorships. Direct Reimbursement Dental Insurance Plan is American Dental Association’s preferred method of dental coverage.

Tips on listing self-employment on your resume

Job Application FormBeing self-employed comes with many challenges – determining your niche, finding clients, having adequate insurance, hiring additional help, etc. To succeed as a freelancer, contractor, or a new business owner, you have to have determination, passion and patience, much of the same characteristics you need to successfully hunt for a new job. So why is self-employment on a resume a concern for your potential employer?

Listing self-employment on your resume when looking for full-time job can raise questions for your potential employer. They will ask questions such as:

- Were you self-employed because you were in between jobs, or because you wanted to start your own business rather than work for a corporation?

- Are you still working on your own, as a freelancer or a consultant? If so, do you intent to continue this work in addition to your full time job?

- Is your self-employment presenting a conflict of interest for the company?

- Are you working as a freelancer or a contractor on part-time basis, and never intend to have this replace full-time employment?

- Does your long-term career goal include owning your own business?

All of these questions are valid from your potential employer’s point of view. Companies do not want to hire you, train you and provide you with benefits only to have you quit after a year to start your own business. This is the main reason previous or current self-employment raises red flags for the hiring organizations. The best way to address any self-employment on your resume is to highlight the positives of working as a freelancer or managing your own business. It is important that your resume includes employment history that is honest and relevant to your career goals.

If you pick up a freelance project infrequently and do not intend to make this a full time career, you can omit any such experience from your resume. The only time you would list occasional freelance work on your resume is if it allows you to fill any gaps in your professional experience. If you have worked as a contractor for a period longer than three months, or if you have ever owned your own business, it is important that you indicate that on your resume. Highlight those attributes of the job experience that qualify you as a perfect candidate for the job that you are seeking. Your job responsibilities should be listed in the same way as they are for any other full-time job you’ve held; focus on those responsibilities which best meet your career objective and quantify your achievements when possible. Exemplify your self-starter attitude under the Qualifications section of your resume. Make sure to list any employability skills you have acquired or strengthened while you were self employed.

As a final indication of your commitment to the job you are seeking. Make sure that your cover letter or email addresses anticipated concerns of your potential employer. Make references to anything on your resume that may raise questions. If you still own your own business, but are looking for full-time work, for example, make sure to let your employer know what your long-term professional goals are and how you intend to balance your roles at both businesses. Don’t apologize for being self-employed. Your resume and cover letter should present you as a credible and passionate professional. Focus on the positive experiences and skills you have acquired as a freelancer, and make sure to let the employer know how these will benefit the company if you are their chosen candidate.

 

Advantages of Offering a Dental Benefits Plan to Employees (Part 2 of 3)

tooth extractionImportant factors while finalizing on a Dental Insurance Plan

An employee has to ask himself the following before he finalizes on a plan:

 Would the employees like to retain the freedom of choosing their own dentists?

Will the mode of treatment be determined by the patient and the dentist?

What type of routine and preventive dental care is covered? Does the plan cover braces, oral surgery, crowns and bridges, root canals and treatment of periodontal diseases?

Will the plan cover all diagnostic, preventive and emergency services? Including preventive services viz. sealants & fluoride treatments, which might result in financial savings to the patient in future? Does it provide for full-mouth x-rays?

What forms of major dental care is covered? Does the plan cover implants, dentures, or treatment for temporomandibular disorders?

Does the plan allow for specialist referrals? If so, has the dentist be limited to “the” list of specialists to choose form?

Does the plan provide for emergencies? What are the provisions made for emergency care when the patient is on tour?

What percentage of monthly premiums goes into actual care and not to administration?

Dental Insurance benefit coverage should be taken into consideration but should not be the deciding factor in choosing the treatment.

 Dental Insurance Plan Models

There are numerous dental plans available. Basically they are of two kinds:

Managed care and Fee-for-service.

Managed care dental plans are restricted forms of dental insurance which aim at reducing costs and payouts. They tend to restrict the coverage by limiting the access to care by restrictions (by predefining dentist, specialist, hospital or treatments in form of lists) and restricting level, type and frequency of treatment (usually in form of clauses in the coverage policy).

Fee-for-service dental plans have a freedom of choice options where one can choose their own dentist and the fee is paid as fixed by the dentist.  ……..(Go To Part 3 next week)