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Frequently Asked Questions


EMPLOYER GROUP DENTAL PLANS

Who is eligible for employer group dental coverage?
What if our company has some employees working in other states?
What kinds of plans are available?
Why should my company use your agency?
Can we enroll on-line?
Why isn't my dentist listed on any of the DHMO plans?
Why do you need so much information to give me quotes?
How do I get dental quotes for my company?
Do you charge for your services?
Why are the DHMO plans less expensive?
Where do I mail the application forms?
What about medical coverage? Do you offer that type of coverage?

 

Who is eligible for employer group dental coverage?
We offer coverage to California based businesses only. To offer group coverage, the employer must be willing to administer payroll deduction, add and delete employees, and pay the monthly premiums. The most comprehensive coverage will be available when the employer contributes all or part of the premium cost and with participation of 75% or more of eligible full-time employees. Some plans do not require the employer to pay any of the premium cost. These are referred to as voluntary plans and provide less comprehensive coverage.

 

What if our company has some employees working in other states?
As long as the billing statements are sent to a California address, this is not a problem. We are licensed to sell insurance in California. Employees of a California based company and residing in other states will be covered under the company's dental insurance policy.

 

What kinds of plans are available?
Please see the descriptions outlined under Group Dental Plans.

 

Why should my company use your agency?
We are unique in that we specialize in dental coverage only. Most insurance agents focus their time and energy on the bigger ticket lines of insurance like medical and know very little about the great variety of dental plans available. Often these agents only obtain one or two dental quotes from the same one or two carriers. They do not keep up to date on changes in the dental insurance market or know which carriers are currently offering the most competitive rates.

In addition, agents who focus on medical insurance will often obtain packaged coverage, so you get your medical and dental insurance from the same carrier. This is easier for the broker and will provide you with the convenience of one bill to pay. However, often a company that has competitive medical rates will not have competitive dental rates. Sometimes, carriers are quoting lower medical rates and bumping up the dental rates to make up for the discounted medical rates.

Another disadvantage of packaging benefits is that many carriers will require your medical and dental enrollment to match. You may have some employees who want medical coverage but do not want dental coverage, or vice versa. You can usually obtain significantly better rates by shopping for medical insurance separately from dental insurance. You will also have more freedom with regard to participation requirements.

We are dental specialists, who will obtain quotes from many reputable carriers to find you the most competitive rates and benefits that suit your needs.

 

Can we enroll on-line?
Unfortunately, most carriers do not offer this option yet. If it is available to your group, we will let you know.

 

Why isn't my dentist listed on any of the DHMO plans?
Dentists who participate in DHMO plans have agreed to charge members of those plans the reduced fees you see listed in the brochures. Only a small percentage of dentists are willing to accept these reduced fees. Most of the plans pay the dentist a percentage of the premium cost (capitation) to help offset the reduced fees that the dentists are accepting.

 

How do I get dental quotes for my company?
Complete the Benefit Design form and Census Data form. We usually have quotes to you within 7-10 days.

 

Why do you need so much information to give me quotes?
That information is required by most insurance carriers in order to give you accurate quotes. Insurance carriers base their quotes on factors that include: type of industry of your business, age of employees, sex of employees, turnover of employees, whether a group has continuous dental coverage, location of business, number of dependents per employee and the percent of employer contribution toward the cost.

The more accurate information we receive from you, the more accurate the quotes we will receive. When the employer contributes more toward the premium cost, more employees enroll. This will result in lower rates per employee. When fewer employees enroll the rates go up.

Voluntary plans, where the employer does not contribute at all toward the cost, will offer the least comprehensive coverage and higher rates because the insurance company is assuming more risk. When fewer employees enroll, those that do enroll tend to be the ones that need the most work and incur the highest claims.

Most of the DHMO plans do not require the same amount of information because they are not paying claims. If you are requesting a DHMO quote we only need your company name, city and zip code, and the number of eligible employees and dependents.

 

Do you charge for your services?
No. The way we earn our living is from the commission the carriers pay us when people enroll through our office. Most carriers pay us between 10% and 20% of the premium amount. Using our service does NOT cost you anything. You will pay the same premium amount, whether you enroll through our agency, direct through the carrier or with any other agency.

We provide quotes with no obligation to purchase through our office. In addition to finding a dental plan that meets your needs, we also provide service to our clients after the sale.

Should you run into any problems with the plan after you are enrolled, we will act as your advocate with the carrier and assist you in resolving the problem. We also will gather quotes at renewal to be sure that you still have the most competitive rates. We weigh rates against other factors such as employee satisfaction and the time and effort required to change carriers.

 

Why are the DHMO plans less expensive?
DHMO plans generally do not pay claims. They have contracted with the dentists on their list to provide covered services at lower fees. Usually the dentist receives a percentage of the monthly premium cost (capitation) to help offset the lower fees. The dentist is assuming the risk by charging lower fees for the treatment they provide and receiving capitation payments that they hope will offset the lower fees they charge.

The DHMO plan has fairly low overhead. They have the expenses of maintaining the provider panel, marketing their plans, issuing ID cards, sending bills and customer service. The biggest expense of a traditional insurance plan is claims administration. DHMO plans do not incur this expense.

 

Where do I mail the application forms?

Dental Insurance Services, Inc.
P.O. Box 5437
Petaluma, CA 94955-5437

 

What about medical coverage? Do you offer that type of coverage?
We specialize in dental coverage only. However, you can request medical quotes from our associate at:

Jordan Shields Insurance
15 Brooke Drive
Novato, CA 94947
(415) 878-0260