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How an HMO Can Streamline Dental Benefits for Your Employees

Offering dental benefits to employees can be advantageous for recruiting and maintaining a strong workforce. According to Delta Dental, “a survey of employee attitudes toward dental benefits found that 70 percent of respondents said that dental benefits coverage is somewhat or very important. If a company drops dental benefits, it compares unfavorably to competitors who offer them.” However, it can be a nuisance in terms of administrative tasks when you try to handle this yourself. That’s why it’s helpful to go through an HMO to streamline the process.


What is an HMO?

Short for Health Maintenance Organization, an HMO provides a variety of healthcare services via a network of providers. This term originated in 1973 when the Health Maintenance Organization Act was passed. The act was designed to cut back on medical inflation and make it so consumers received an array of healthcare benefits to accommodate individual needs.

While there are no HMO requirements for smaller businesses with fewer than 25 employees, companies with 25 or more employees that offer traditional health insurance are required to offer federally certified HMO options. One area of healthcare that’s commonly covered is dental benefits where members can have numerous procedures performed. Some common ones include:

  • Routine oral examinations
  • Fillings
  • X-rays
  • Crown, denture and bridge repair
  • Oral surgery


How Does an HMO Work?

You start by first choosing dentists within an HMO so employees can receive full benefits. While it’s sometimes possible to go out of network with an alternate dentist, this usually ends up costing more and full benefits may not be offered. From there, you can choose between different plans depending upon on how comprehensive you want the dental benefits to be.

For instance, a basic plan may only cover cleanings, examinations and fillings. Anything beyond that would come completely out of pocket, and employees would have to pay a larger percentage of their fees. On the other hand, a more comprehensive plan might also cover bridges, dentures and oral surgery for less out of pocket expenses, and employees would pay a lower percentage of their fees.


Simplify Your Dental Benefits Program

By going through an HMO, you can make sure that your employees get the dental coverage they need while saving you from much of the paperwork. As long as the dentist submits a claim, you have little to no paperwork to deal with so you’re free to focus on other aspects of business. An HMO should also be able to negotiate considerably lower fees than if employees visited dentists outside of a network.

In many cases, these are between 10 to 35 percent of regular fees. After getting set up on many plans, your group premium will automatically be paid via payroll deductions so you have even less to deal with. Other than the initial set up, there’s very little required from you and an HMO takes care of the bulk of the paperwork.

If you’re looking for an effective way to offer your employees dental benefits without much hassle, going the HMO route is a great choice. That way you can take care of your workforce and lighten your administrative tasks at the same time.

dental benefits

4 Things You Need to Know When Offering Employees Dental Benefits

Taking care of the health of your employees is important, and there is a pretty big emphasis on oral health these days. With multiple healthcare options through avenues like the Health Insurance Marketplace and Human Resources Outsourcing (HRO) available, it’s never been easier to find great dental benefits for your workforce. Before getting started and looking for coverage, there are four main things you need to know.


1) Dental Benefits Budget

First of all, you need to have a rough idea of how much you’re willing and able to spend for coverage. Plans can vary in pricing considerably, and the more features you offer means the more you will typically spend. For very basic plans with examinations and routine cleaning, you can usually afford them even with a minimal budget.

For more comprehensive features like x-rays, fillings and oral surgery, you can expect to pay significantly more. Also, it will be less expensive to only provide coverage for an individual employee rather than for them and their other family members. That’s why you need to crunch the numbers and see what your budget is before proceeding.


2) Your Employee Needs

Because your employees are the ones who will be receiving coverage and their oral health is at stake, it’s important to understand their specific needs. In some cases, basic dental benefits are sufficient and extensive features are overkill. Other times, this just won’t cut it and your employees will prefer more exhaustive coverage. Prior to choosing an insurance provider, it’s a good idea to go over dental benefits with your workforce and get a general consensus on what everybody thinks about the situation.


3) Policy Coverage

You will definitely want to know all of the details and subtle nuances of a policy before jumping in head first. Consequently, it’s necessary to thoroughly look over a provider’s schedule of benefits. It’s imperative that coverage is adequate enough to meet the needs of your employees, but without going overboard to the extent that there are needless features. Also, be sure to look at the deductible and co-payment to ensure that they’re to your liking before signing up.


4) Policy Provider Credentials

Finally, it’s a good idea to do some research into a potential provider. You might want to look at how long they have been in business, their professionalism, their caliber of customer service and overall credentials. They should also have an effective claims processing system in place because keeping up with paperwork can be an arduous process. Even if you’re going through a healthcare exchange, you should at least do a little research and check out some unbiased reviews before making up your mind.

By offering dental benefits, you should be able to strengthen rapport and have happy employees who are well taken care of from a health standpoint. With a little planning, you can find the right coverage through a reputable provider and ultimately “right-size” the dental benefits of your employees.