This article was recently published by The Voluntary Benefits Magazine in June 2010 in Issue 14, found at www.voluntarybenefitsmagazine.com. The information discusses dental options for businesses and employers for their employees. Thanks to the magazine for publishing this material.

Going to the dentist takes time. If you’re a working man or woman, you typically will need to miss time away from the office or your jobsite when you go to your appointment. Even if you only go for a cleaning once every six months, that still counts as time missed for productivity that otherwise would be beneficial towards your economic betterment. However, not going to the dentist for even minor preventive procedures will definitely result in more serious oral health issues later that require even a greater amount of time missed from work.

According to a report issued by Employee Benefit News, dental illness is the most common of all chronic health concerns and accounts for significant loss of workforce productivity and significant health care costs. Studies show workers who get their dental care completed and maintain good oral health do far better on the job than those who do not. Oral health reduces the chance for emergency visits and the pain and discomfort that can harm a worker’s focus and confidence. Workers, confident about their family’s health, are more focused, productive and secure. Absenteeism for dentist visits, pain, discomfort and poor self-confidence harm production, employee confidence and quality of life across the corporate community. Reports from the last 10 years provide some detail regarding the impact of oral health on the workplace.

Workers experience 164 million hours of lost work time each year due to dental visits. The country’s annual cost for general dental care is estimated at $60 billion dollars, which does not account for cranial facial care and care for oral problems, such as oral cancer or chronic pain syndromes. These medical costs are estimated to average $100,000 per individual for the lifetime care required to address these oral illnesses and developmental problems.

Dental insurance coverage can influence people’s decisions to use dental care. During 1996, 42.9% of all dental expenditures were paid by private dental insurance. During 1997, less than 50% of Americans visited a dental office. Americans made approximately 292 million dental visits and received approximately $30 billion worth of dental care, of which $10 billion was paid by insurers, $17 billion was paid out of pocket and $1.6 billion was not reimbursed. National data shows that, even with dental insurance, out-of-pocket expenses for dental care are about 50% of the total cost as reported by the study.

Here are some amazing stats offered by the Dental Aid website:

• 95% of all Americans are afflicted by oral disease. Oral Cancer is more common than leukemia, melanoma of the skin, Hodgkin’s disease and cancers of the brain, liver, bone, stomach, thyroid gland, ovaries or cervix.
• Lost work due to dental problems equates to 164,000 American workers off the job for the entire year.
• 140 million Americans do not have dental insurance.
• Upon retiring, 85% of Americans have no dental insurance.

Employee Benefit News goes on to say that studies increasingly demonstrate the health and cost implications of oral illness to well-known chronic illnesses. Poor oral health impacts diabetes, heart disease, stroke, prenatal health, pneumonia and brittle bone disease in women. Common medications for blood pressure and mood disorders can harm oral health. Dental care costs exceeded the costs for cancer and diabetes.

Workers desire dental care as an important part of benefit programs. In fact, workers select health programs that include dental care at a greater rate than when medical benefits are offered alone. As reported by the U.S. Department of Labor’s Bureau of Labor Statistics, about 80% of workers participate in benefit programs if dental care is part of the program. And, approximately 92% of unionized employees and 75% of nonunion workers select dental coverage if offered. This behavior is fairly consistent nationally. However, only 46% of the nation’s workers have access to dental care through an employee benefit program. Although employers can offer dental care benefits, this does not mean that the employee receives appropriate care. Common mouth infections, tooth decay, bleeding gums, bone loss around teeth and oral malodor are consequences of risky behaviors and poor self-care. The information about these statistics has been made available in the Employee Benefit News Survey.

The Health and Human Services Department states that oral diseases can affect individuals, their family, the community, and society as a whole. Oral health problems can affect a person’s ability to maintain a job or get promotions. They can also contribute to lowered academic achievement and goals. These effects have increased likelihood when a deformity due to the oral health condition is involved. Families may be affected if an individual cannot perform household functions or play his or her usual role in the family due to an oral health condition. Since some population groups bear a heavier burden of oral disease than others, the effects on these communities may be more pronounced than on the population as a whole.

According to Gaebler.com, small business owners often feel like they are at a disadvantage because they can’t absorb dental insurance premiums as easily as larger companies. But you might be surprised to learn that you have a lot of options – and some may be more affordable than you think. Like health insurance, dental insurance improves the overall health of your labor force. By making it easier for your employees to access preventative measures such as regular cleanings and periodic x-rays, you can reduce the amount of time lost for extensive dental procedures. Less time lost translates into greater efficiency in the workplace and a healthier bottom line for your company.

There are several options to consider as an employer, according to Gaebler.com:

Direct Reimbursement

A direct reimbursement plan is technically only an insurance plan from the employee’s perspective. Rather than relying on a third-party insurer, the employer offers in-house dental coverage for employees by paying for dental expenses from a cash reserve the employer sets aside exclusively for this purpose. Dentists love these kinds of plans because they don’t restrict the amount they can charge for services. But they are also the most costly for employers. The participation rate, often up to 20% as a general average, can be low as the cost for the insurance on a voluntary basis can be expensive.

Indemnity Plans

Indemnity plans are traditional insurance plans in which a third-party insurer collects premium in exchange for dental coverage. As an employer, it’s much more convenient than a direct reimbursement plan because you can accurately budget for it based on the amount of your annual premiums. Employees, on the other hand, can be left holding the bag for dental costs that exceed the amount the insurance will pay. Co-pays and deductibles are standard features as well, so the out-of-pocket costs for your workers can quickly add up.

Managed Care Plans

Managed care plans are possibly the fairest plans because no one is completely satisfied. Like an indemnity plan, a third-party insurer provides employee coverage for dental care. But the difference is that managed care plans are subject to certain cost-cutting measures that restrict both patients and dental care providers. Employees are forced to select treatment from a list of providers distributed by the insurer. In return for being included in the plan, providers’ fees are determined in advance by the insurer. Although they are usually still required to come up with a copayment, the big benefit for patients is that they are no longer required to cover service fees that exceed insurer limits. Business owners generally favor these plans because they are the least expensive option.

Discount Dental Plans

For extreme savings on dental expenses, a discount plan is the least costly way to go, and typically are 10% of the cost of traditional dental insurance. Also, there is no waiting, unlimited use, and no forms to complete for reimbursement or any claims process. Employees go to a participating dentist and pay a significantly reduced price at the time of service to the provider. In many cases, the plan design may also include all household residents in addition to the primary member. Savings can be anywhere from 20% to 60% and all procedures are included at a discounted rate—including general dentistry, all specialties, orthodontia, cosmetic and much more. There are several great discount networks in the market place including Careington, Aetna, and others.

The website for Employee Benefit News continues its overview of dental health and employee behavior. Healthy behaviors that support oral health go far beyond a healthy smile. People usually do not receive oral health information specific to their situation, nor do they know the benefits of timely dental visits for preventive care. Each person’s risk for poor oral health is specific to his or her lifestyle and general health and can be measured through questionnaires about behaviors and situations that are significant to oral health and general health. Individuals will certainly respond to information that is specific to them, removes misconceptions about oral problems and helps them to become wise consumers of health care. Personalized oral health education can be easily facilitated through secure, interactive online risk assessment tools provided by a corporate wellness program at very low cost. This approach can significantly benefit the entire corporate community, provide precise data for program evaluation, direct timely dental preventive health care and reduce overall health care costs.

Today, most employees share in the cost of their dental benefits, but few can choose between coverage levels. According to MetLife research, 84% of employees said they share or pay the entire cost of their coverage, but only 17% have a choice of plans. Employees who are engaged in choosing their level of coverage want more choices to be made available to them. Sixty-seven percent of employees who have choices are likely to agree they want more choices in cost and coverage; and when employees understand their benefits, they are willing to pay more for more appropriate coverage.

In truth, though, not all patients face the same dental risk, according to WorkForce.com. Risk can be altered by the patients’ history of cavities and gum disease, whether they smoke or drink, and even vulnerability to conditions like dry mouth. Emerging research also indicates that untreated gum disease may be associated with other medical conditions, including heart disease and diabetes. Still, providing coverage doesn’t guarantee that employees will use the benefits, whether the underlying reason is dental-chair nerves or simply an overbooked schedule. There’s a real hard core of patients who will not seek dental care no matter what.

Preventive dental care could significantly reduce loss of productivity and catch problems before they become chronic or severe, according to AllBusiness.com. Regular dental evaluations may also reveal surprising information about seemingly unrelated health issues. Medical professionals have identified at least 120 medical symptoms that can be detected in the mouth during routine dental checkups, including skin diseases, mental illness, diabetes, thyroid problems, leukemia, cancer or hardening of the arteries. In fact, bleeding gums, etched enamel and other tissue changes in the mouth are often the first clues to serious health problems. Medical studies have also revealed that pregnant women with gum disease are seven times more likely to have babies that are born too early and too small.

Lost time, lack of productivity, employee health, and reduced revenues are all critical reasons to make sure that employers should encourage workers to maintain good oral health. Providing access to a quality a dental plan at affordable rates will help reduce the problems associated with employees who have problems related to poor oral health. A quality dental plan can be a valuable benefit to help keep employees at work. This is the tale of the everyday workin’ man—the absolute tooth.

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About Mark Roberts

My professional sales background includes almost 30 years of sales and marketing \ in the tax, insurance, and investment markets. I have contributed to the CAREINGTON sales team in a variety of aspects, such as developing marketing materials and designing benefit plans, responding to RFPs, and adding both individuals and new groups to CAREINGTON membership. Part of my responsibilities include attending client conferences as a vendor rep for the company; and since September, 2001, I have also worked with the company to help recruit a network of hundreds of outside agents, re-sellers, and affinity groups to market CAREINGTON products. Currently serving as Manager of National Accounts, my key focus is developing relationships with large national membership groups, insurance plans, employers, unions, and financial institutions. I am known as the hunter on our sales team, and have been privileged to work with many of our top clients in various areas of responsibility. Additionally, I assist individual retail consumers interested in our services.My specialties also include almost 30 years experience in Sales and Marketing. I also serve as account manager to clients including financial institutions, insurance companies and national association groups. I am also a licensed life, health and accident insurance agent in all 50 states and DC, and I have participated in multiple large national employer open enrollments for worksite products including limited medical benefit plans, short term disability, term and universal life policies, cancer and critical illness policies, and many other insurance products offered through our sister company, Core Five Solutions, a nationwide insurance agency and licensed third party administrator.Additionally, I have been writing a health care blog for the past 2 years, found at www.yourbesthealthcare.blogspot.com
which is a topical weblog about various health care issues.  

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