Posted By:

Trish Barnes on September 11, 2014

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.