Based upon paid claims, both the specific deductible and the aggregate deductible stop-loss program for the employer's self-funded benefit plan is initially calculated and these deductibles are recalculated each year. These deductibles may either increase or decrease annually.
With the inclusion of stop-loss insurance, the employer is assured that the cost of the benefit program will not exceed a predetermined amount. Plus, the self-insured employer has the option of increasing or decreasing this "retention" level, or deductible amount, each year.
By working with a good benefits administrator and a good stop-loss carrier, an employer can hold down ancillary benefit program costs and tailor benefits and provider lists to fit employees like a pair of comfortable spectacles.
Renny Thomas II is chief operating officer and senior vice president of corporate development for Dentafits/RX Reins, Palm Springs, Calif., a nationwide prescription drugs, dental and vision underwriter of aggregate stop-loss insurance.
Who Has Dental == And Who Needs It
Worker Participation In Dental Plans | |
Characteristics | Participation in % |
All workers ……………………………………… | 36 |
Worker characteristics | |
White-collar occupations ………………….. | 42 |
Blue-collar occupations ……………………. | 39 |
Service occupations ………………………… | 17 |
Full time …………………………………………. | 45 |
Part time ………………………………………… | 9 |
Union …………………………………………….. | 67 |
Nonunion ……………………………………….. | 33 |
Average wage less than $15 | 24 |
Average wage $15 per hour | 52 |
Establishment characteristics | |
Goods producing …………………………….. | 49 |
Service producing ……………………………. | 33 |
to 99 workers ……………………………….. | 24 |
100 workers or more ……………………….. | 51 |
Geographic areas | |
Metropolitan areas …………………………… | 37 |
Nonmetropolitan areas …………………….. | 31 |
New England ………………………………….. | 36 |
Middle Atlantic ………………………………… | 36 |
East North Central …………………………… | 38 |
West North Central ………………………….. | 34 |
South Atlantic …………………………………. | 34 |
East South Central ………………………….. | 36 |
West South Central …………………………. | 30 |
Mountain ………………………………………… | 33 |
Pacific ……………………………………………. | 44 |
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Source: Bureau of Labor Statistics, National Compensation Survey, March 2005 |
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