The sponsor of this type of plan should consider what copayments and annual maximums should be established as well as whether the plan will be administered in-house or by a third party. Normal utilization profiling is collected with these plans. Traditional Indemnity Plans These plans provide a predetermined level of payment for a specific list of services covered under the plan. The level of payment is based on a defined fee structure. Co-payments are normally part of these plans.
Patients can visit the dentist of their choice.
Table of Allowance Plans Table of Allowance programs specify a maximum dollar benefit for each covered procedure, regardless of the fee charged. Managed Care Plans Preferred Provider Organization Preferred Provider Organizations offer plans under which participating dentists agree to a pre-set schedule which is often at a level below the usual fee the dentist charges. As individual dentists' fees will vary, it may be helpful to have a range of fees that the plan would pay. Capitation Plans Capitation programs pay dentists a fixed monthly amount per enrolled family or patient. In return, the dentist agrees to provide a specific level of treatment or scope of benefits to the patients, as necessary.