Self-funded vs Fully Insured Dental Plans: Which is Right for Your Company?

April 16, 2019

When it comes to choosing funding for your company’s dental plan, you have options. We want your funding arrangement to work best for your situation, which is why Dental Select offers both fully insured and self-funded options for group dental plans. So the question is, which option makes the most sense – self-funded or a fully-insured plan?

There are advantages to both options, but first, let’s break down the two.

 

Fully Insured

With a fully insured plan, the employer to manage the plan, and then the carrier takes responsibility for paying future dental claims. There are different costs associated with managing a fully insured plan, but this means the risk for future claims may also be assumed by the insurance carrier.

 

Self-Funded

What Is the Advantage to Assuming Financial Risk?

With self-funded plans, employers can save on costs that may be associated with a fully-insured dental plan. Cost savings and benefits from a self-funded plan can include:

  • Eliminating premium tax
  • Lowering operation costs
  • Wider plan design flexibility
  • Paying a low administrative fee each month
  • Eliminating insurance underwriting costs
  • Cost-saving plan design options

If you are considering a self-funded dental plan, it may be helpful to have wellness programs in place to support lower utilization and therefore manage costs.

Note that self-funded groups have access to our national network, which means employees and their family members can visit more than 200,000 provider access points across the United States. And just like our fully-insured groups, we’ll provide ongoing account maintenance and reports, help you customize your dental plan and allow cost savings on negotiated fees with our contracted dentists.

 

Fully Insured vs Self-Funded

 

  Fully Insured Self-Funded
Financial Risk Carrier assumes all financial risk. Employer assumes all financial risk.
  Premiums. Monthly administrative fee and claims reimbursement
Plan Designs Some flexibility, but regulated options. More plan flexibility and customization.
Claims Cost Same amount during contracted year. Can vary month to month.
Minimum Participation Must meet minimum participation guidelines established by the carrier. Self-funded groups will establish their own participation requirement.
Billing 25th of each month (auto pay) or generated on the 15th of each month. Decided upon during contract process.
Account Support Included. Included.
Network Access to national network with more than 200,000 provider access points. Access to national network with more than 200,000 provider access points.

 

Ready to compare some dental plans? See all our employer plans here. Ultimately, we encourage you to talk to your broker or Dental Select representative to discuss which funding option is best for your company.