Group Dental Insurance


There are two different ways to pay for Group Dental Insurance.

1.  Company sponsored, where the company is required to pay at least 50% of the cheapest plan (usually a HMO) ranging from $10-15. Typically this would give 5-10 medical plan options for all to choose from.  The company’s contribution ($10-15) is removed from the various plan costing options.

2. Voluntary dental plans. Any company would be wise to let any employee who wants to buy dental insurance on there dime to do so, because the employee and employee win/win in saving on taxes when pre-tax dollars are used.


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There are eight types of Group Dental Insurance

1. HMO-Health Maintenance Organizations

This is the second-most popular type of plan, but its popularity pales in comparison to PPO plans, coming in at about 8% of all policies. This is a more affordable plan for patients because there is no deductible, a low monthly premium, and only a predetermined fee for non-preventative dental procedures. Preventative procedures are fully covered. There tends to be no waiting periods, so you can usually get oral health care right away with an HMO plan.

2. PPO- Preferred Provider Organizations 

A PPO plan regularly combines with a network of dentists under contract to the insurance company to deliver specified services for set fees and according to the provisions of the contract.

Contracted dentists must usually accept the maximum allowable fee as dictated by the plan, but non-contracted dentists may have fees either higher or lower than the plan allowance.

3. POS -Point of Service Plans

Point of service options are arrangements in which patients with a managed care dental plan have the option of seeking treatment from an “out-of-network” provider.  The reimbursement to the patient is usually based on a low table of allowances; with significantly reduced benefits than if the patient had selected an “in network” provider.

4. DHMO’s. Dental Health Maintenance Organizations

Under a DHMO, contracted dentists are “pre-paid” a certain amount each month. This money is designated for each patient and assigned to that dentist. Dentists must then provide certain contracted services at no-cost or reduced cost to those patients. The plan usually does not reimburse the dentist or patient for individual services and therefore patients must generally receive treatment at a contracted office in order to receive a benefit.

5. DR- Direct Reimbursement (DR®)

Benefits in this type of plan are based on dollars spent, rather than on the type of treatment.  Direct reimbursement is a self-funded plan that allows patients to go to the dentist of their choice.  Depending on the plan, the patient pays the dentist directly and then submits a paid receipt or proof of treatment.  The administrator then reimburses the employee a percentage of the dental care costs. 

6. Discount or Referral Plans

Discount or referral plans are technically not insurance plans. The company selling the plan contracts with a network of dentists.  Contracted dentists agree to discount their dental fees. Patients pay all the costs of treatment at the contracted rate determined by the plan and there are no dental claim forms to file.  Originally these plans were sold to individuals; however, more and more employers are purchasing these types of plans as the dental plan for the company’s employees.

7. EPO-Exclusive Provider Organizations 

Exclusive provider organization plans require that subscribers use only participating dentists if they want to be reimbursed by the plan.  These closed panel groups limit the subscriber’s choice of dentists and also can severely limit access to care.

8. Indemnity Plans

An indemnity dental plan is called “traditional” insurance. In this type of plan, an insurance company pays claims based on the procedures performed, usually as a percentage of the charges.  Generally, an indemnity plan allows patients to choose their own dentists, but it may also be paired with a PPO. Most group dental insurance plans have a maximum allowance for each procedure referred to as “UCR” or “usual, customary and reasonable” fees.

They each have a pro and a con. Along with, varying waiting periods. Let a California Business Benefits employee see which types of plans makes sense for your company and your employees.

Get a free, live quote on individual dental on our Live Quotes page.