Is Your Dental Plan (or Lack of One) Decreasing Worker Wellness?

As recent research continues to show the many benefits of people maintaining and improving their oral health, the spotlight is on dental insurance plans as a way for employers to reduce their overall healthcare costs and display their investment in workforce wellness.

But according to data released in September by the U.S. Department of Labor’s Bureau of Labor Statistics (BLS), dental care is available to only:

• 30% of workers at small employers (those with less than 100 employees);
• 50% at midsize employers (100 to 499); and,
• 70% at large employers (500 or more).

That means a large percentage of American workers may be bringing tooth pain and other health issues — and any affiliated physical and mental distractions — to work with them.

Or, those workers may not show up at all. A study by the National Institute of Dental and Craniofacial Research found adults annually lose more than 164 million hours of work due to dental diseases. 

Access a bonus Workspan Daily Plus+ article on this subject:

• Stop Guessing: 3 Steps to Measure Dental Plan Efficacy

Dental problems don’t get better on their own, said Dr. Mark Vitale, a spokesperson for the American Dental Association (ADA), adding that early treatment is the easiest and most affordable way to fix them.

“Your mouth is [a critical] part of your body,” he said, “and many times, systemic disease has manifestations in the mouth that are caught at routine dental visits.”

Research shows dental problems can lead to serious health conditions, since germs entering the body through a person’s gums can cause inflammation in the heart and other organs. A recent study cited in a Washington Post article also shows root canals may help lower cholesterol and reduce the risk of heart disease and Type 2 diabetes.

For employers that offer dental benefits, Vitale said, “encouraging employees to take care of their oral health is a smart investment in their well-being and productivity.”

This article examines what you need to know about adding (or enhancing) your dental insurance offerings as part of a wellness-focused total rewards strategy.

Rinse and Review

With more than 60% of surveyed workers calling dental insurance a “must-have” or “important” benefit, it makes sense from a total rewards standpoint to offer it, said Michael Adelberg, the CEO of the National Association of Dental Plans, an advocacy and research non-profit.

Dental insurance typically ranks behind only medical insurance in most employees’ preferences as well, he added.

“It’s an employee recruitment and employee retention tool,” Adelberg said.

Many dental plans, however, look fine on paper but don’t work well in practice, said Mark Burkhard, the national dental and vision practice leader at consulting firm WTW.

“Employees may face limited networks, low annual maximums or unexpected costs that discourage routine care,” he said. “At the same time, plans need the right guardrails to protect against unnecessary or excessive treatment.”

Burkhard said when HR and total rewards (TR) professionals periodically review their organization’s plan, they are taking proactive steps to ensure coverage levels and reimbursement are aligned with clinical guidance. Such efforts, he said, also work to encourage effective and appropriate preventive care, and discourage overutilization that drives up costs without improving outcomes.

“When dental benefits are well-designed, employees are more likely to get preventive care and address problems early,” he said. “That reduces emergency visits, limits disruption at work and improves how employees feel about their benefits overall.”

But when dental care is not provided or poorly designed, individuals typically “delay treatment, experience pain or infections, and often blame the employer when costs spike unexpectedly,” Burkhard said.

Patterns, Payments and Pockets

The experts interviewed for this article recommended that HR/TR pros start examining their dental programs and processes by understanding how the benefit is actually being used.

“Look at utilization patterns, network access and where employees are paying the most out of pocket,” Burkhard said. “From there, total rewards teams can modernize plan design, adjust coverage where it doesn’t align with clinical norms and improve communication so employees know how to use the benefit effectively.”

The focus, he said, “should be on practical changes that improve access, affordability and consistency.”

Preventive care utilization is a key indicator, Burkhard said, and organizations can periodically assess whether emergency dental claims decline and whether employee satisfaction improves.

“Progress is reflected not just in costs,” he said, “but in fewer problems and clearer expectations for employees.”

One of the more effective approaches for comparing plans/carriers may well lie in reviewing the annual reports filed with state insurance authorities, said ADA’s Vitale.

“While it is time consuming and worthy of reform with respect to ease of use,” he said, “the annual reports do hold valuable information HR executives may find useful.”

Networking Needs

Another ongoing consideration for HR/TR pros is assessing the breadth and quality of their provider’s network of dental practitioners, said Joanne Fontana, a principal and actuary at consulting firm Milliman, Inc.

Are employees able to access care when they need it, or do they have to go out of network, she asked. And if so, why?

“I think employers should challenge their dental insurance partners to help them understand [the answers to those questions],” Fontana said.

Ultimately, any type of in-depth examination of dental benefits requires coordination across teams within an organization, said Burkhard, adding HR/TR pros should work closely with consultants, dental carriers, underwriters and actuaries, along with their internal partners in corporate communications. “Employee feedback also provides insight into real-world experience,” he said. “Dental works best when it’s treated as part of a broader health and rewards strategy,” Burkhard said, “not a standalone benefit.”

Editor’s Note: Additional Content

For more information and resources related to this article, see the pages below, which offer quick access to all WorldatWork content on these topics:

• Employee Benefits
• Well-Being