The Plan:
Dental Decisions is tailored to fit the needs of each individual employer with the following shared characteristics:
- Complete freedom of choice regarding dentist & specialist
- Assignment of benefits feature
- Flexible dollar-based plan design
- No deductibles, limitations, or exclusions regarding treatment*
Sample Plan Designs
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100% of the first $100
50% thereafter to a
$500 annual maximum
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100% of the first $150
60% thereafter to a
$1000 annual maximum
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100% of the first $200
70% thereafter to a
$2000 annual maximum
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*Cosmetic services may be excluded in some cases. |
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The Employer:
- Controls plan design & contribution level
- Establishes payroll deduction program for participating employees
- Deposits funds in administrative trust account managed by DABP
- Evaluates plan performance at renewal
- Receives monthly transaction reports and detailed quarterly claims reports
- Retains excess funding at year end
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The Employee:
- Receives ID card and toll free number to verify benefits
- Visits dentist of their choice and selects treatment plan
- Pays office visit co-payment and any applicable coinsurance
- Pays for majority of dental services with pre-tax dollars
- Online accessibility - personal claims history
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The Dentist:
- Accepts office visit co-payment from each patient
- Calls 800 number to verify benefits & address claims issues
- Determines necessary treatment
- Submits standard ADA claim form to DABP for processing
- Receives payment from DABP within 7-10 business days
- Collects remaining balance (co-insurance) from patient
- No fee schedules, provider contracts, exclusions or limitations
- Ability to submit claims electronically
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When a dentist chooses not to file, the plan reverts to
direct reimbursement:
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- Patient pays for services
- Patient remits standard ADA claim form directly to DABP for processing
- Benefits paid directly to patient, less office visit co-payment, any
applicable co-insurance, and additional $5 withhold.
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The Administrator:
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Dental Decisions is a group dental plan administered by Direct Assignment Benefit Plans, Inc.
DABP is dedicated to establishing and maintaining a high level of personal service with
each of its clients. (Staffing consists of account managers, senior claims
examiners, customer service representatives and in house technical support personnel.) Claims
personnel are accessible through a toll free number during normal business hours. Employers
will receive specific executive and administrative contacts at plan implementation. Our
primary objective is to reduce standard administration and marketing costs that can run
anywhere between 15-50% of premium, then pass the savings along to plan participants.
This is accomplished through efficient plan design and an agreement from the dentists to help
pay the cost of plan administration, resulting in increased benefits and/or reduced cost to
plan participants. Additionally, a one-time set up fee of $2.00/employee* ($350 minimum) is
required at plan installation. This fee covers initial set-up, plan documents, and ID cards.
*Subject to number of enrollment meetings &
locations required.
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