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Dental/Vision Plans
We can offer dental and vision through employer groups often with a bundled discount if other benefit products are purchased. We can also offer a stand-alone plan for individuals and families.
Dental Plans
You have many options to decide what coverage you need. There are DPPO’s, DHMO’s, Indemnity Plans, and Discount Plans that give you access to specific networks and save you money with negotiated rates. Some plans have waiting periods, while others increase coverage benefits over a 3-yearperiod, have roll-over amounts from year to year, as well as orthodontia or implant benefits. All dental plans have an annual maximum the plan will pay. The higher the maximum benefit, the more the premium
| May Include | DPPO Dental Plan | DHMO Dental Plan | Indemnity Plan | Discount Dental Plan |
|---|---|---|---|---|
| Deductibles | $50/150/ or $200 Ind/Fam/or LifeTime (waived for preventative) | $50/150/ or $200 Ind/Fam/or LifeTime (waived for preventative) | May have a Deductible | None |
| Preventative | Usually 100% Covered if in-Network/80-95% Out-of-Network may Balance bill | Usually No Cost or Small Co-Pay if in-Network/No Out-of-Network Benefits | Pays you a specific amount depending on your benefit level; may pay dentist directly | Simple Fee Schedule ( Savings of 50-70%) if in-Network / No Out-of-Network Benefits |
| Basic Services | Usually 50-80% if in-Network/60-75% Out-of-Network may Balance bill | Usually 50-80% if in-Network / No Out-of-Network Coverage | Pays you a specific amount depending on your benefit level; may pay dentist directly | Simple Fee Schedule ( Savings of 50-70%) if in-Network / No Out-of-Network Benefits |
| Major Services | Usually 50% if in-Network/30-45% Out-of-Network may Balance bill | Usually 50% if in-Network/ / No Out-of-Network Coverage | Pays you a specific amount depending on your benefit level; may pay dentist directly | Simple Fee Schedule ( Savings of 50-70%) if in-Network / No Out-of-Network Benefits |
| Benefit Maximum | Usually $1000-$2000 if in-Network / Out-of-Network may Balance bill | Usually $1000-$2000 if In-Network / No Out-of-Network coverage | May be able to purchase a higher Benefit Maximum to cover more dental work | None |
| Waiting Periods | Usually, None for Preventative, 6 mos. Basic/12 mos. Major Waived if coming off other coverage | Usually, None for Preventative, 6 mos. Basic/12 mos. Major Waived if coming off other coverage | Usually, None for Preventative, May have for restorative care 3-12 | None |
Vision Plans
Vision insurance is generally supplemental to other types of medical insurance policies. Stand-alone Vision Plans help offset the costs of routine checkups, frames, lenses and contacts that are prescribed. There are also discounts for other in-network covered services and on lasik at participating providers.
| May include | Vision insurance plan | Vision discount plan | Major Medical plan |
|---|---|---|---|
| Eye Exams | Annual Exam; usually co-pay | Pre-Negotiated Rates or Discounts | Ophthalmology Eye Health Exam |
| Frames | Co-pay / Frequency 12 or 24 mos. | Pre-Negotiated Rates or Discounts | No Benefits |
| Lenses | Co-pay / Frequency 12 | Pre-Negotiated Rates or Discounts | No Benefits |
| Contacts | Co-pay / Frequency 12 | Pre-Negotiated Rates or Discounts | No Benefits |
| Allowance | Usually $130 – $200 annually | Pre-Negotiated Rates or Discounts | No Benefits |
| Waiting Periods | Usually None | None | Usually None |
Dental and Vision Care Riders
Dental and vision care can also be purchased as an add-on, also known as a rider with many health care policies. This is generally less expensive than purchasing a separate dental and vision plan, but may offer slightly less coverage.
Employer groups can offer dental and vision plans along with group life and disability to round out their benefit package for their employees. They can be contributory (employer helps pay some of the cost) or voluntary(employee pays entire cost). When these benefits are bundled together we can typically shop them and get better premiums.