Reimbursement...a self-funded dental plan so cost-effective it will reduce your
dental plan costs up to 25% to 35%
Give us a few minutes and
we'll show you how this unique program...
- Can help you better
control and manage your costs.
- Can keep your
dental plan money at home where it can earn for you.
- Can save you the
unnecessary costs of a traditional insurance program
is...and is not..
Direct Reimbursement is a simplified form of self-funded dental coverage
that reimburses employees or pays the Dental office direct for incurred
dental expenses. Employees receive treatment from the dentists of their
choice, pay the bill and submit a copy of the paid receipt or canceled
check to the plan administrator, who then pays a predetermined percentage
of the bill. Or the Dental Office submits a claim to Benefits
Administration, Inc. and is
Reimbursement is not insurance so there are no perplexing claim forms to fill out, no
premiums to pay for employees who do not receive dental service and no
insurance company involved.
Understandably, many benefit managers fail to realize that dental risk is
vastly different from medical risk. Unlike medical risk, dental risk is
highly predictable and is completely free of catastrophic loss. In
addition, dental expense, unlike medical expense, experiences stable
inflation. Estimating finding costs, therefore, can be done with a high
degree of confidence.
Experience with hundreds of Direct Reimbursement plans already
implemented indicate that employers can expect about 60% of employees to
utilize the benefits. With Direct Reimbursement, employers pay only
for those employees who do utilize the plan rather than paying
insurance premiums for all employees.
Why is Direct
more flexible than traditional dental coverage?
Direct Reimbursement enables an employer to determine coverage based on what
management and employees wish to spend. Plan payments typically range from
50% to 100% of costs. Annual maximum benefits may range from $500 to
$1,500 and up. If there is an existing dental plan, the benefit levels in
that plan can be duplicated. Instead of complex fee schedules, the
benefits need only be stated in terms of dollars spent.
Why do employers
like Direct Reimbursement?
- It can save money
by lowering the cost of benefits and reducing administration expense.
- The employer
retains total flexibility and control.
- Small as well as
large companies, with or without an existing self-insured medical plans,
can utilize Direct Reimbursement.
- Simplicity is
- Funds budgeted to
pay claims stay with the employer and can earn interest.
- The employee
identifies with the employer as the benefits provider rather than an
insurance company, thus morale improves.
- Co-payment factors
and maximum annual ceilings help control costs and limit employer annual
risk; thus, plan cost increases can be eliminated or, at the very least,
- The plan is
extremely cost-effective compared to traditional insurance dental
programs and even cost-effective with advantages for plans that are
Why your employees
will like Direct Reimbursement:
- It's easy to
understand and they know the amount of reimbursement they'll receive
before visiting the dentist.
- They need only
provide proof of payment and a simple statement from the dentist to get
reimbursed. No complex claim forms. If a credit card is utilized for
payment, the employee is usually reimbursed prior to receipt of the
credit card billing.
- It offers them the
freedom to select the dentist of their choice.
- There are typically
no exclusions, restrictions or pre-existing conditions.
- There are no
pre-authorization requests from insurance companies.
- A greater portion
of dental care dollars goes to actual treatment.
- It has enriched
benefits, it's simple and it's hassle-free.
What are the
advantages of Direct Reimbursement?
- Plan costs are
based on actual dental expenses incurred, not on premium payments by
employer/participant regardless of use of service.
overhead costs typically are reduced-it's simple and cost-effective.
- Flexible plan
design may include deductible, co-payments and an annual maximum
- Plan is easy to
implement at any time of the year.
- Employer and
employees find plan easy to understand and easy to use.
- Eliminates waiting
periods, as well as exclusions and limitations.
- The freedom to use
dentist of choice is ensured.
- Fosters efficient
consumer-driven dental care planning.
- Employer dollars
stay at home and can earn interest.
- Dentists in the
community will appreciate and support Direct Reimbursement.
Why Use The Benefits Administration, Inc.?
The Benefits Administration, Inc. is
endorsed by the Virginia Dental Association with 3,500 members. The
American Association of Orthodontist with 13,500 members worldwide.
Benefits Administration, Inc. has been promoting Direct
Reimbursement Dental Plans since 1978
We have over 100 Direct
Reimbursement clients nationwide
For a single administrative fee per
employee, per month Benefits Administration, Inc. will provide:
Prompt and accurate dental claim
Plastic ID cards provided
Employee Benefit Summary Booklets
Summary Plan Descriptions
Toll Free 800 Customer Service Number
FAX number for claim form submission
Web based enrollment and client plan
Benefits Administration, Inc. staff offers over
18 years of
Dental Benefit Administration and service experience