Dental Plan Review

Assess dental plan design, annual maximum, orthodontia coverage, and network adequacy.

Created by Corry Hull, REBC®, CSFS® for Employer Benefits IQ.

1.How well does your dental plan annual maximum ($1,000–$2,500 typical) reflect current dental care costs and employee utilization?

Annual maximums have not kept pace with dental cost inflation. Many employers are moving to $2,000–$2,500 maximums.

2.How well does your plan design incentivize preventive care through 100% coverage for cleanings, exams, and X-rays?

Preventive care at 100% is the market standard. Deductibles on preventive care reduce utilization and increase downstream costs.

3.How well does your orthodontia benefit (lifetime maximum, age limit, adult coverage) meet employee needs?

Orthodontia lifetime maximums of $1,500–$2,000 are common. Adult orthodontia coverage is increasingly expected.

4.How adequate is your dental network for your employee population, including access to specialists and pediatric dentists?

PPO networks vary significantly in size and quality. Out-of-network cost exposure should be reviewed annually.

5.How well does your dental plan coordinate with your medical plan for oral-systemic health conditions (diabetes, cardiovascular disease, pregnancy)?

Oral-systemic health connections are well-documented. Enhanced dental benefits for high-risk medical conditions can reduce medical costs.

This tool provides educational decision support only. Results are not legal, tax, actuarial, or insurance advice. Validate all outputs against current plan documents, applicable law, and qualified professional guidance. Scoring version 1.0 · Reference year 2026.