Group Dental Coverage. For your employees

Group Dental Coverage For your employees Dental coverage for your employees can take care of more than just teeth Dental coverage is one of the mos...
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Group Dental Coverage

For your employees

Dental coverage for your employees can take care of more than just teeth Dental coverage is one of the most valued employee benefits. It’s also a savvy business strategy to help you attract and keep the best employees. Additionally, studies prove that people with better oral health are healthier overall — they miss fewer days, and that’s good for business.

CareFirst offers a variety of dental plans* to meet both your employees’ needs and your budget. Choosing from a range of plans and out-of-pocket cost options gives you more control over your costs and what your employees contribute.

› Better administrative efficiency — using CareFirst for

All three plans described in this guide cover employees’ regular exams and cleanings, X-rays, dental surgery and more. Orthodontia services are standard with the Dental HMO Plan (DHMO), but can be added to our other plans. You can also offer voluntary dental plans, meaning your employees are responsible for paying the total dental premium amount at no cost to you.

›  Online convenience — you can quickly enroll or update

Whether your employees are close to home or across the country, there’s a plan that offers access to a national network of over 94,000 dental providers.

Why offer a Traditional or Preferred plan from CareFirst? › Familiar providers — CareFirst members utilize in-

network providers 80%–90%1 of the time, so there’s a good chance your employees already see a participating dentist. › Superior service — CareFirst’s dedicated Dental

Customer Care Unit resolves close to 90%2 of inquiries in one phone call or email exchange.

medical and dental insurance gives you an experienced clinical team to oversee utilization reviews and cost management. eligibility information for employees on your plans. › Anywhere access — employees can easily find a

provider, view their ID card and access claims information from a computer, tablet or smartphone. › Pre-existing conditions are covered — even missing

teeth. › Extensive diagnostic and preventive benefits —

coverage for composite fillings is one of the standard features for CareFirst dental plans. › Industry-leading discounts — help stabilize your costs

with CareFirst’s network reimbursement schedules. › Significant savings — CareFirst’s lower provider

reimbursement fee schedules mean your savings can range from 27% to 34% when using the Participating or Preferred Dental Networks. Need more information? Your broker or CareFirst sales representative can help you select a plan that’s best for your employees, and best for your bottom line.

*Plans are presented by CareFirst BlueCross BlueShield (CareFirst), CareFirst BlueChoice, Inc. (CareFirst BlueChoice) and The Dental Network. 1 Regional average based on 2013. 2 Regional data for 2013–2014.

Traditional Dental Plan Coverage Freedom to choose any dentist Largest network of dental providers

Orthodontia coverage for

Employees can choose from more than 4,000 local providers and over 94,000 providers throughout the United States with the national Dental GRID+. The GRID links dental networks — including many of the nation’s Blue Plans — so your employees’ dentists may already participate with CareFirst and the national network.

Freedom to choose any dentist Employees can even choose to see a dentist outside of our extensive participating network. While their out-of-pocket costs will be higher, you’ll be giving them a flexible benefit that they’ll appreciate.

National coverage With the Traditional dental plan, your employees can select a provider from one of the largest national dental networks — the Dental GRID+.2 Linking networks across the country, Dental GRID+ allows your employees to select from more than 94,000 unique dental providers. No matter where they are, your employees can always find a dentist. When they see a participating provider, your employees will get covered services at the in-network level of benefits. It’s a hassle-free opportunity to access more network dentists and discounts across the country.

children can be added to all of our Traditional and Preferred (PPO) dental plans.

Save money Employees who see a participating dentist in the CareFirst Traditional Provider Network will get significant advantages. Network dentists offer care to plan members at a discount. And they accept CareFirst’s allowed benefit as payment in full for covered services. Seeing an in-network dentist saves your employees money by lowering their out-of-pocket costs.

How the Traditional plan works When an employee visits a participating dentist, they simply show their member ID card. They have no claims to file and are only responsible for their deductible and coinsurance amounts. And remember, many of our plans cover preventive care at 100%. If employees visit a dentist who doesn’t participate with CareFirst or Dental GRID+, they are still covered. Their outof-pocket expenses may increase and they’ll need to file their own claims. They’ll also lose the advantage of getting fee discounts from a participating dentist. Dental GRID+ is a service of GRID Dental Corporation, an independent company offering access to a dental provider network and services to CareFirst members.

2 

Preferred Dental Plan Coverage Offer choice and savings Large regional network

3 options for care

Employees can choose from more than 3,600 local providers across Maryland, D.C. and Northern Virginia. They’re all part of CareFirst’s Preferred Provider Network.

When your employees need care, they’ll have three dental plan options to meet their needs.

Option 1

National coverage Our Preferred dental plan gives your employees access to the national Dental GRID3 discount network and its more than 71,000 providers. The Dental GRID links dental networks, including many of the nation’s Blue plans. With dentists in all 50 states, your employees can find a dentist wherever they are at the in-network level of coverage. It’s a hassle-free way to access more network dentists and discounts whenever your employees find themselves in need of quality dental care.

How the Preferred plan works After meeting their annual deductible, your employees can save money by paying a lower coinsurance amount when they see a dentist in the Preferred Provider Network. Plus, when they see a Preferred dentist for care, they won’t have to file a claim form.

In-network coverage from a dentist who participates in the CareFirst Preferred Provider Network.

Employees get: › The lowest out-of-pocket costs › Quality care from dentists who accept CareFirst’s allowed

benefit as payment in full, with no balance billing › Freedom from filing claim forms › Higher coverage for dental services › Many services without a deductible

Option 2 Out-of-network coverage from a dentist who participates with CareFirst, but not through the Preferred Provider Network.

Employees get: › Quality care from dentists who accept CareFirst’s allowed

benefit as payment in full, with no balance billing

Next to medical coverage, dental coverage is one of the most important health care benefits you can offer employees. It can help you attract the best employees and keep them longer. Source: WB&A Market Research

› Convenience of direct reimbursement to provider

Employees pay for: › Out-of-network deductible and coinsurance

Option 3 Out-of-network coverage from a dentist who has no relationship with CareFirst.

Employees pay for: › Services directly to provider › Balance-billed amount up to provider charges › Deductible and coinsurance 3

Dental GRID is a service of GRID Dental Corporation, an independent company offering access to a dental provider network and services to CareFirst members.

Dental Health Maintenance Organization (DHMO) Lower-cost coverage with predictability CareFirst BlueChoice, Inc. partners with The Dental Network (TDN) to offer our DHMO plan. Your employees will enjoy the emphasis on prevention that this type of dental coverage provides.

Every dollar spent on checkups

Predictable costs

care keeps your employees

With a DHMO plan, employees can expect predictable costs for the care they receive from dentists in the DHMO network. They’ll have access to all dental services for the cost of a copay, with most basic services costing $20 or less. There are no deductibles to meet and no claim forms to file.

High-quality local network The DHMO Plan gives employees access to a network of dentists across Maryland, D.C. and Northern Virginia. To find a participating provider, your employees can access our online directory at www.carefirst.com. Since the dentists in our provider networks — including the DHMO — are committed to providing quality dental care, each office also participates in an on-going quality assessment program.

saves the patient up to $50 in emergency treatment. Preventive healthy and productive at work. Source: Academy of General Dentistry

Orthodontia savings for the whole family Adults and children are eligible for orthodontia benefits as part of their Dental HMO plan.

How the Dental HMO plan works After choosing a dentist from the DHMO provider network, employees simply show their member ID card and pay the related copay for the services they need. The dentist submits all the necessary paperwork.

Away-from-home dental emergencies? They’re covered, too!

10455 Mill Run Circle Owings Mills, MD 21117 www.carefirst.com CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield, CareFirst BlueChoice, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc. This is a summary of the dental plan product options available. Additional information and policy form numbers are available upon request from your broker or CareFirst sales representative.

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