SOURCE: Business Benefits Insurance

July 13, 2007 14:33 ET

When Your Dental Plan Is Stuck in the Eighties, Ask for a Complete Dental Plan Analysis, Says Jim Edholm, President of Business Benefits Insurance

BOSTON, MA--(Marketwire - July 13, 2007) - "In 1985 dental plans [were] described as '100/80/50 to $1000 with a $25 deductible,'" says Jim Edholm, President of Business Benefits Insurance, a benefits planning firm. Twenty years and plenty of inflation later, the typical plan is the same; covering 100 percent of "preventive" procedures, 80 percent of "basic" procedures, and 50 percent of "major" procedures. The only difference: dental plans of 2007 have $50 deductibles. "Do you really believe that dentistry has changed as little as the typical dental plan has in the last two decades?" Edholm inquires. "Probably not."

Though plans have recently been cheapened to help control costs of growing procedures like root canals and gum surgery, "there are other changes too -- changes often ignored by brokers and unknown to HR managers -- that could let the plan profit from today's technology," Edholm writes in an article recently published in the Worcester Business Journal.

Today, Americans face a growing epidemic of periodontal disease, now believed to be transmissible. Aside from links to low birth weight babies, heart disease, and strokes, the estimated 75 percent of American adults with periodontal disease should have dental cleanings four times per year to treat their condition. "But, alas, most plans only cover two cleanings," Edholm writes, which only allows conditions to worsen. "If your plan allowed appropriate quarterly cleanings with diagnosed periodontal disease, your employees could avoid serious dental surgery and might even have lower health claims."

Edholm explains other dental procedures and conditions (TMJ treatment, white posterior fillings, biopsies for oral cancer, and crown replacements) that, like periodontal disease, are becoming more prevalent yet remain uncovered by most dental plans. "Most plans cover things that aren't needed and don't cover things that are," Edholm writes.

He advises people to insist that their broker or consultant conduct a complete dental plan analysis, and if they get a blank stare, to "find another broker! It's too important to ignore." To read the full article "Is Your Dental Plan Stuck in 1985?" click http://group-insurance-guide.com/support-files/je_dentalplan_rev.pdf.

Jim Edholm is president of Business Benefits Insurance (BBI), an employee benefits planning firm in Andover. He has worked with employers for more than 25 years and can be contacted at 978-474-4730, via his web site (www.bbibenefits.com), or via e-mail jedholm@bbibenefits.com.

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