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Give Your Dental Benefits A Check-up

By: Rosemary Peros

Canadians place a great deal of importance on their employer-sponsored dental benefit plans, says Rosemary Peros, of Manulife Financial. Given this, she recommends that plan sponsors give their dental plan an annual check-up.

Since April is National Oral Health Awareness month, it’s the perfect time to book an appointment with the dentist for a check-up. It’s also the perfect time to carve out some of our day and review the dental benefit plans offered to plan members. Even though dentistry has evolved from a time when Classical Roman physicians thought tooth decay was caused by “corroding humors” to today where micro-dentistry can treat the smallest carie before it becomes a full-blown cavity, we need to ask ourselves if modern Canadian dental benefits programs have kept pace with the evolving needs and wants of plan members and plan sponsors.

In a recent study by the Massachusetts Institute of Technology, participants were given a list of items and asked to choose the ones they “can’t live without.” Of all the options given – including cars, personal computers, and cell phones – it was the lowly toothbrush that topped the list. Here, in Canada, when Sanofi Aventis released its 2004 Healthcare Survey, plan members ranked dental coverage equal to health after drug benefits in level of importance. This survey makes it clear that Canadians place a great deal of importance on their employersponsored dental benefit plans and they certainly have a strong desire to have that coverage continue.

Increasing Costs
The increasing costs associated with offering comprehensive employee benefit plans is top-of-mind for most sponsors when reviewing their plans. Employers realize the role played by benefit packages – including drug and dental coverage – in attracting the best job candidates and maintaining their employees’ good health. Over the past five years, the annual rise in drug plan costs was approximately 15 to 18 per cent and dental benefits rose seven to 10 per cent. Insurance companies are under increased pressure to offer innovative solutions that help control these price increases, while, at the same time, balancing the needs of plan sponsors and members. What options can insurance companies offer plan sponsors? Certainly, the old stand-bys such as dollar maximums, copayments, and deductibles are still effective tools to be used in managing costs, but, in today’s environment, these solutions no longer seem adequate.

The United States offers one example of a viable alternative. American-style, managed care models control costs by restricting patient access to pre-selected ‘in-network’ dentists. Nevertheless, the limited types of services covered by these plans and reduced reimbursement to dentists may make this solution difficult to introduce to Canadians. Another option chosen by an increasing number of employers is the introduction of flexible benefit plans. This benefit program model puts the onus on members to choose the most appropriate type of coverage for their personal situation. Employers give a predetermined number of ‘credits’ or dollars to each plan member and then participants choose what they see as the best way to allocate their credits. Since employees choose their own benefit structure, plan sponsors have an effective way of controlling costs because the expenditure is fixed and predictable.

Member Education
A third and often-overlooked option is plan member education. Plan members need to be aware that the ultimate responsibility of combining the best value for their benefit dollar rests squarely on their shoulders. Plan sponsors provide benefits packages and insurers administer them, but reminding members of their crucial role in ensuring that benefit cost increases are minimized is important. Sponsors should create clear communications about what’s covered in their plans and emphasize the importance of making informed and well-researched choices about their course of dental treatment.

Regardless of the option pursued, the ultimate goal is to provide the best value possible for each benefit dollar. Benefit plans play a highly regarded role in the lives of plan members and their families, contributing to their overall personal wellbeing. Plan sponsors want to provide these benefits to their employees so that they will continue to be healthy, productive members of the organization. Insurers seek to provide their clients with the best services and value to ensure continued affordable and effective benefits.

As the dental profession continues to advance, so too must the dental benefits industry. The ultimate challenge remains in finding the optimal balance between goals of plan members, plan sponsors, and insurers. Only then will the road ahead be a healthy one and that’s a good reason to smile!


Rosemary Peros is a group benefits product manager for Manulife Financial.

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