Self-Funded Access & Administration Frequently Asked Questions
Q: What is a Self-funded Plan?
A: Self-funded is when an entity (ie. Welfare Fund, Teachers’ Union, School District or business), retains an organization such as a Third Party Administer to administer their dental benefit. The entity is responsible for actual claims experience (dental procedures performed rather than an Insurance Premium) for the participants. Usually leasing a dental network, such as Sele-Dent is incorporated in this service.
Q: What are some advantages in choosing a Self-funded Plan?
A: Typically, a self-funded plan may offer better benefits and provide significant savings to the entity, as opposed to traditional indemnity plans. Furthermore, when choosing a self-funded option, the plan sponsor may design a specific dental plan which is customized to the group’s needs and dental requirements.
Q: How large of a group should go Self-funded?
A: There are various schools of thought on this question. Our organization believes in most circumstances, a group should be over 400 employees to consider a Self-funded option. However, Sele-Dent does not provide Fully-Insured dental quotes for smaller groups better suited for a traditional indemnity plan. Sele-Dent does not administer fully insured plans. Sele-Dent does not administer fully insured plans.
Q: Is it difficult to go Self-funded with Sele-Dent, Inc.?
A: No. Sele-Dent, provides Consultations for benefit plan options. Sele-Dent processes all dental claims in- house , manages all banking arrangements, handles all customer service and provides a comprehensive proposal and implementation. It is virtually simple, easy and painless to go Self-funded with Sele-Dent.
Q: What are the benefits of choosing a Sele-Dent Participating Provider versus a Non-Sele-Dent Provider under a Self Funded Plan?
A: It is very important to choose a Sele-Dent Participating Provider. This is not a HMO type plan; it is a PPO– Preferred Provider Organization. Therefore, in most cases, groups with Sele-Dent, pay benefits for non Sele-Dent providers as well. However, if you choose a Sele-Dent Provider, you will in many cases, have no out-of-pocket expenses and may receive considerably more dental services within your plan maximum, as opposed to visiting a non-participating provider.
Q: How does Sele-Dent handle quality control of its network?
A: Sele-Dent performs a rigorous background check for applicants to the network. This includes academic degrees, licenses, Insurance documents, active DEA number and conducts on-site visits to make sure our members have the finest treatment possible. Sele-Dent, Inc. ensures our network provides the highest quality dental care to all our groups and their members.
