Some plans limit referral to specialists. Note procedures not covered by the plan. Request a copy of the DHMO's contract with the dentist. It may detail the treatment your employees are entitled to receive. A self-funded concept through which employers pay dental benefits to employees without insurance company involvement.
Employees receive treatment from the dentist of their choice.
The employer or TPA reimburses the employee based on a pre-determined rate, not exceeding the annual maximum benefit allowances. Advantages Freedom of Choice. Employees choose their own dentist, including specialists, and may change at any time. DR plans have few, if any, treatment restrictions or exclusions. Administrative costs are low.