ODASC’s new health insurance plan helps member dentists and their staffs avoid additional costs, save money

The Ohio Dental Association Services Corp. (ODASC) is excited to announce its new health insurance plan, the Ohio Dental Association Wellness Trust, will officially go into effect March 1. The new plan is a self-insured plan that will allow participants to avoid some of the regulations and requirements of the Affordable Care Act.

The Wellness Trust is a private, dentist-owned, self-funded health benefit plan, developed by Ohio Dental Association member dentists for ODA member dentists and their staffs to provide high quality health insurance at affordable rates.

Advantages of a self-insured health insurance plan include the ability to design plan and deductible options, choose networks and features, and keep costs low by avoiding the state insurance premium tax and many of the ACA’s mandated taxes. According to industry research, a typical self-insured group can expect to save more than 10 percent (versus traditional health insurance) without having to sacrifice quality of care.

The Ohio Dental Association Wellness Trust will have the same carrier (Medical Mutual of Ohio), the same networks of providers and hospitals, the same prescription coverage and same plans as the ODA’s current health insurance plan, the Dentists’ Choice Health Care Plan (DCHCP).

The Wellness Trust will be an employer plan (as opposed to an individual plan like the DCHCP). This means that offices that enroll in the trust will be required to offer insurance to all full-time employees (defined as those employees working 25-30 hours or more per week). No employer contribution is required, and employees are allowed to decline the coverage by completing a waiver form.

An employer plan may be advantageous to dental offices even if the dentist chooses not to make a contribution to employees’ premiums because employees can use pre-tax dollars to pay for the premiums, whereas an individual plan’s premiums would need to be paid for with after tax dollars.

Paying  directly for an employee’s individual health insurance plans puts the employer out of compliance with federal regulations and may be subject to a $100/day excise tax per applicable employee (which is $36,500 per year, per employee) under section 4980D of the Internal Revenue Code.

Because benefits are not guaranteed by a traditional health insurer, all self-funded plans have some level of risk that arises from unexpected catastrophic claims or the timing of the claims. Because of this, the Wellness Trust has purchased stop-loss coverage to re-insure that possible risk. An actuarial study done by the Wellness Trust estimated that there is less than a 0.5 percent chance that the trust would be impacted by a catastrophic claims situation.

To receive coverage starting March 1, participants must enroll by Feb. 15. The ODA Wellness Trust will be open to all member dentists and their employees. New enrollees should email insurance@oda.org or call (800) 282-1526 to enroll.

People who are currently enrolled in the DCHCP should have received a letter with instructions on how to enroll in the new plan. Offices that are enrolled in the DCHCP and did not receive a letter should contact an ODASC representative at (800) 282-1526 or insurance@oda.org. As a reminder, current DCHCP enrollees must enroll in the Wellness Trust by Feb. 15 to receive deductible credits and to keep their same rates.