Dollar Based Dental

With Dollar Based Dental,

You're In The Driver's Seat

Affordable Dental Plans That Make Sense. Call Us Today To Find Out More!

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About Dollar Based Dental

Affordable Dental Plans That Make Sense

Dollar Based Dental is a self-funded dental plan for employers which pays providers based on a Dollar Based Plan as opposed to paying via a network agreement and procedure codes. With a Dollar Based Dental plan for your employees, you can keep costs down while providing superior dental care options for everyone at your company. Dollar Based Dental Plans are supported by the American Dental Association, and the dental profession, as they allow for superior dental care while remaining fee for service. With Dollar Based Dental plans you and your employees can enjoy:

  • Control over your dental care. Your employees pick the dentist they see.
  • Affordable costs. With Dollar Based Dental, your plan costs are based on actual dental costs incurred, not premium payments paid by employers or plan participants.
  • 90% of your benefit dollars go to actual dental care, not insurance companies.
  • Available to small and large companies, with or without an existing self-insurance plan.
  • Co-payments and maximums on total benefits prevent unpleasant surprises at the end of the year. Plan cost increases can thus be minimized or eliminated.
  • Eliminates pre-authorizations, limited choices for dentists, and typically no exclusions for preexisting conditions.
  • We’re the low-cost dental plan that saves employers money, while letting employees enjoy hassle free dental services from the provider of their choice

Dollar Based Dental

  • Benefits assignable to providers – No Out of Pocket costs for participants!
  • Employers can design the plan any way they want...customized and not off-the-shelf. The employer retains control.
  • Benefits are based on a percentage of a specified dollar amount up to an annual maximum.
  • Your employees have freedom of choice – there is no network.
  • You have a better dental plan at less cost.
  • Can include any dental and/or vision care
  • No exclusions or limitations unless put in place by the employer
  • No predetermination required
  • Employer becomes the insurance carrier and saves on the admin and profit.
  • Self-funded, Simple, User Friendly, No UCR

What Employees want in a dental plan.

  • Freedom of choice - to go to provider of choice, quality provider, ability to stay with family dentist
  • User friendly - simple, no confusing handbooks, no UCR/limitations and complications.
  • Treatment decision between patient and provider.
  • Quick reimbursement/simplicity
  • Assistance from employer in meeting dental and medical costs.
  • All dental procedures covered.
  • No exclusions for pre-existing conditions.
  • No long waiting for appointment for a network of providers.

Why Employers offer dental benefits.

  • Encourages employees to seek routine dental.
  • Reduces absenteeism.
  • Increases employee loyalty.

Dollar Based Employer - Process.

  • Choose a plan Design
  • Review account
  • Claims are processed by Eagles, Benefits by Design, Inc 

Dollar Based Employee - Process.

  • Employee chooses their own dentist
  • Employee and health care provider determine treatment.
  • Dentist can prequalify
  • Employee incurs expense.
  • Dentist submits claim form as proof of treatment (physical or electronic)
  • Provider is paid from the dental claims account.
  • Employee is reimbursed if they paid for dental care out of pocket.

Why use Self-Funded Dental Plans?

  • Plans build reserves (money goes back to employer)
  • Dental costs are predictable, unlike medical costs.
  • No need to insure/manage costs that are non-catastrophic.
  • No need to insure/manage costs that are low-risk and low cost.
  • Overhead Compared
    • Indemnity/Insured 25% – 30%
    • HMO/DHMO 30% – 40%
    • Traditional/self-funded 10% – 25%
    • Dollar Based Dental Plans 5-10%