Dental & Vision Benefits

Foundation Publication Search Results

These summaries were compiled from Foundation Publications Search, a database of articles, research reports and books published by the International Foundation and the International Society of Certified Employee Benefit Specialists.


Board Refuses Government Motion to Bifurcate Case on Postretirement Benefits.
Godkewitsch, Clio; Plans & Trusts; v35 no2 pp 29, 31 Mar-Apr 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The Grievance Settlement Board is a body that provides dispute resolution services to the Crown and unions representing employees in the Ontario Public Service. In the context of a grievance challenging the Crown's unilateral changes to postretirement benefits (PRBs), the board refused the Crown's motion to first hear a "no prima facie case motion."
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Dental Benefits: A Standout Option.
Wilson, Dennis; Benefits Magazine; v53 no9 pp 50-54 Sep 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Both employers and employees consider dental benefits important. This article discusses some of the factors a plan sponsor should consider in choosing a dental benefits carrier.
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Employee Benefits Survey: 2016 Results
Held, Justin; Mrkvicka, Neil; Stich, Julie; 70 pp 2016; survey

Availability : International Foundation of Employee Benefit Plans
Abstract : Results of the fifth comprehensive benchmarking survey conducted by the International Foundation. Includes data on pension and retirement plans, health care benefits and other benefits, such as life insurance, work/life benefits and time off, for three distinct sectors in the U.S.—corporations (including professional service firms), public employers and multiemployer benefit plans. Responses were gathered from members of the Foundation and the International Society of Certified Employee Benefit Specialists during 2016.
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Dental Wellness: The Approach to Deliver Better Dental Care at a Lower Cost.
McGowan, Donald; NewsBriefs; v33 pp 21-22 4th Qtr 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Employers faced with significant increases in their dental costs might consider a dental wellness approach to their dental benefits.
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The More Things Change: Benchmarking Collectively Bargained Private Sector Benefits.
St. Jacques, Riley; Petruniak, Jane; Plans & Trusts; v33 no3 pp 14-19 May-Jun 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : A PBI Actuarial Consultants survey of 41 Canadian public and private sector multiemployer plans reveals commonalities and differences useful for benchmarking. Plan designs have changed little since the 1980s, but accelerating technological change challenges the status quo. The PBI survey found most private sector multiemployer plans offered long-term disability to age 65, though some limit benefits to five years. All provide some vision and hearing benefits, though benefit levels are falling, while corporate plans tend toward choice through flexible health spending accounts. Only one in 20 private multiemployer plans have prescription drug dispensing fee limits, in contrast to the majority of corporate and public sector plans. Virtually all private multiemployer plans cover massage, a benefit for about half the other plans. No private sector multiemployer plan surveyed offered a health and wellness spending account, but nearly half of public sector plans did.
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Ancillary Benefits Can Help Build a Healthier Workforce.
Kaufman, Philip; Benefits Magazine; v52 no4 pp 46-49 Apr 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : By offering supplemental benefits such as vision, dental, disability and life insurance, employers can support employees' health and extend health benefits at low or no cost. The employer may contribute to the premiums for these voluntary benefits at a manageable and predictable level or simply make them available at a favorable group rate. A 2014 LIMRA International report shows voluntary benefits enhance recruitment and retention and improve employee morale, serving individual needs. Integrating supplemental benefits with medical benefits and wellness offerings provides comprehensive health care, with the supplemental care often detecting or monitoring significant medical conditions. Dental and vision checkups may reveal early signs of diabetes and other illnesses, and attending to oral, eye and hearing problems can avert some serious diseases from developing and contribute to employee productivity.
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Third-Party Administrators and Shareholder Misappropriated Funds.
Benefits Magazine; v51 no12 p 64 Dec 2014; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The District Court for the Northern District of Illinois held in Board of Trustees of the Health and Welfare Department of the Construction and General Laborers' District Council of Chicago and Vicinity v. Allison Enterprises, Inc. et al. that the defendants breached their fiduciary duties by misappropriating plan assets. The court found that the two defendant companies and their sole shareholder were correctly considered a single entity for purposes of the claim. It held that since the money in question was given to the defendants in order to allow the plaintiff's participants and beneficiaries to use the defendants' vision care provider network, the money constituted plan assets as defined by Labor Department regulation. The court also found that the defendants were functional fiduciaries because they controlled the disposition of these assets. The court found the inclusion of the shareholder in the claim to be appropriate, found that the funds were inappropriately used for the defendants' business-related expenses, and ordered for an accounting of the defendants' assets and a submission of damages from the plaintiff.
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Employee Benefits Survey 2014.
International Foundation; 63 pp; survey

Availability : International Foundation of Employee Benefit Plans
Abstract : Results of the fourth comprehensive benchmarking survey conducted by the International Foundation. Includes data on pension and retirement plans, health care benefits and other benefits, such as life insurance, work/life benefits and time off, for three distinct sectors in the U.S.—corporations (including professional service firms), public employers and multiemployer benefit plans. Responses were gathered from members of the Foundation and the International Society of Certified Employee Benefit Specialists during 2014.
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Seeing the Benefits of Vision Plan Options.
Sherman, Gene; Benefits Magazine; v50 no11 pp 50-54 Nov 2013; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Vision disorders lead to an estimated $8 billion loss in productivity each year, but employers can reap up to $7 in return for each dollar invested in employees' vision health. Vision insurance is commonly offered as a voluntary option. To boost utilization of the benefit, especially for comprehensive eye exams that can reveal serious disease conditions, employers can offer a variety of vision plan designs with special features suited to their workforce. These include safety eyewear, UV protective eyewear, computer vision aids, progressive lenses, lens coatings, vision therapy, laser surgery, a second pair of glasses and even hearing benefits. An employee survey is useful to identify enhanced benefits that would be most suitable to the employee group.
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Trend Worthy of Smiles: Lowering Dental Insurance Costs.
Sherman, Gene; Benefits Magazine; v49 no10 pp 38, 40-42 Oct 2012; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Understanding that good dental hygiene and preventive care contribute strongly to overall physical health, 61 percent of employers offer group dental benefits. While all dental plans help lower financial barriers to care, details vary, including the dental preferred provider organization, pure indemnity, dental health maintenance organizations, managed fee-for-service and discount plans. The employer must be aware of features and limits when selecting a plan, such as monthly premiums, network size and dentist proximity, types of services covered, enhanced benefits for some members, deductibles and annual maximum coverage. Under the Patient Protection and Affordable Care Act, coverage for children's services will expand and health insurance exchange participant may face certain requirements, affecting dental plans. One way employers can control costs is through customized plans to best suit their employee needs.
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Dental Benefits: A Guide to Managed Plans.
Smithwick, Cathye L.; 587 pp 3rd ed. 2012; book

Availability : International Foundation of Employee Benefit Plans
Abstract : This primer and reference book concerning dental benefits covers: how dental benefits are different from medical benefits; benefit plan design and pricing; available dental products (e.g., HMOs, PPOs, indemnity plans, voluntary plans); choosing a dental plan and plan administrator; the role of the dental consultant; measuring plan performance; tackling fraud and abuse; the connection between oral and systemic health; coordinating dental and medical care; using technology to empower consumers.
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Court Identifies Controlling SPD for Benefits Determination.
Benefits Magazine; v48 no8 pp 56-57 Aug 2011; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The Seventh Circuit Court of Appeals in Huss v. IBM Medical and Dental Plan et al. said a benefits decision should be based on the summary plan document (SPD) in effect at the time the plaintiff's opportunity to meet the conditions for the benefit expired. The plaintiff had been denied coverage for her disabled son based on a 2006 SPD, which would have required a written request by June 2004. The plaintiff contended, and the courts agreed, that a 2003 SPD was applicable. A district court had granted the plaintiff benefits based on its reading of the 2003 SPD. However, the Seventh Circuit disagreed with the district court's reading of the SPD, saying it was ambiguous, and remanded the case back to the district court.
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Survey Examines Value of Dental Coverage.
Graziano, Vincent; Benefits & Compensation Digest; v45 no11 pp 24-27 Nov 2008; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : For years, health plan sponsors have focused their cost-management efforts on their largest expenditure (medical coverage) and the expenditure growing at the fastest rate (prescription drug coverage). It is important for plan sponsors not to overlook the value of dental coverage, which is typically the third most utilized health care coverage, after medical and prescription drug coverage.
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Other Recent Decisions.
Benefits & Compensation Legal & Legislative Reporter; v42 no7 pp 15-16 Jul 2008; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : In Gertjejansen v. Kemper Insurance Companies, Inc. the Ninth Circuit Court of Appeals upheld the district court's ruling denying permanent disability benefits to the defendant because the defendant did not cooperate in repeated attempts to schedule a case management appointment. In Virga et al. v. Big Apple Construction & Restoration Inc. et al., the court held both the defendant liable and the defendant company's president personally liable for unremitted contributions of $730,280.22 plus interest and statutory damages, costs and attorney fees. In O'Meara v. The Cit Group, Inc. the court concluded that dental work contracted for, dental work begun and payment made for that dental work in a given year is an eligible expense for that year and should be paid by the defendant's flexible spending account.
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Top Ten Questions to Ask Vision Plan Providers.
Newsome, Paula; Benefits & Compensation Digest; v44 no12 pp 32-36 Dec 2007; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : According to research by the Vision Council of America, vision problems and eye injuries cost employers about $8 billion yearly in lost productivity. Workers with vision problems often experience eyestrain and headaches on the job, particularly if they work at a computer more than three hours a day. Much of this loss could be prevented by regular eye exams and access to high quality lenses and frames. Employers should consider adding vision care coverage to their benefits packages, and benefit managers need to understand the options available from vision care providers.
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The Link Between Gum Disease and Cardiovascular Risk: Taking Care of Employees' Oral Health.
Sweeting, Larry A.; Benefits & Compensation Digest; v44 no10 pp 24-25, 27-30 Oct 2007; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The evidence associating periodontal disease with heart disease and other systemic health risks stemming from chronic bacterial infection is clear. Employers can avoid significant costs from worker absence, reduced productivity and major health complications by ensuring that dental benefits cover gum disease treatment, including antibiotics recommended by the American Dental Association. About 30 percent of the population are genetically susceptible to gum disease, and smoking, pregnancy and stress are known risk factors. Educational materials can raise awareness, and employer-sponsored screenings and enhanced benefits for those at risk encourage appropriate followup treatment.
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Dental Benefits: Growth and Stability in a Changing Market.
Dolatowski, Thomas; Benefits & Compensation Digest; v43 no9 pp 16-19 Sep 2006; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : While medical insurance premiums have soared, dental coverage has increased by well under ten percent annually for some time. Changes in out-of-pocket expenses and annual limits have been negligible. This predictability has encouraged employers to offer dental benefits, much valued by employees. Dental benefits which encourage regular preventive care can enhance employee wellbeing and forestall costly periodontal disease, dental restoration and systemic illness.
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Ancillary Discount Programs: A Clear Vision for Benefit Cost Savings.
Foley, John; Benefits & Compensation Digest; v43 no8 pp 30-32 Aug 2006; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Supplemental vision care benefits are welcomed by many employees, especially older workers. Though almost 60 percent of employed Americans need vision correction, fewer than one in three employers offers the benefit. Linking vision benefits with highly valued dental insurance reinforces overall health care at little additional costs for the employer. Some insurers offer discount vision programs as a free or low cost upgrade for new dental plan customers. Plan members can use health savings accounts, health reimbursement arrangements or flexible spending accounts, if available, to pay for out-of-pocket costs.
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Other Recent Decisions of Significance.
Legal-Legislative Reporter; v40 n08 pp 11-12 Aug 2006; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : In Balestracci et al. v. NSTAR Electric and Gas Corporation, the First Circuit Court of Appeals ruled that dental benefits were not vested and guaranteed by the company's early retirement program (ERP). The plaintiffs argued the company could not retract the benefits. The court agreed with the defendant's right to modify the plan, plan documents and ERP documents and observed that the right was explicitly stated in the documents. In Garrett v. Circuit City Stores, the plaintiff claimed he was fired because of military duties and sued under the Uniformed Services Employment and Reemployment Rights Act (USERRA) rather than relying on arbitration as required by company policy. The district court found that the USERRA overrode the arbitration requirement, but the Fifth Circuit Appeals Court reversed that decision. The appeals court ruled that the USERRA's focus is not on procedural rights and that USERRA claims are subject to arbitration under the Federal Arbitration Act.
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Health and Dental Benefits Fraud: The Bottom Line.
Nicholas, Robert M.; Employee Benefit Issues: The Multiemployer Perspective - 2005; pp 104-107 2006; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Fraudulent health care and dental care claims can be costly for benefit plans and can cause plan costs to rise for employees. Employers should consider a zero tolerance policy to communicate that they are serious about controlling fraud and that fraud is a serious problem. Employers should also consider educating employees about the potential impact that fraud has on them, and should encourage employees to report evidence of benefits fraud or abuse. Employers and employees should be aware of certain signs of possible fraud, such as altered claim documents or a claim that gives the same address for the provider as for the claimant. Providers as well as employees participate in fraudulent practices.
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Health and Dental Benefits Fraud: The Bottom Line.
Nicholas, Robert M.; Benefits & Compensation Digest; v42 no12 pp 18-21 Dec 2005; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Though medical and dental abuse or intentional fraud represents less than one percent of claims, the final cost is a huge portion of the $15 billion in annual claims paid. Fraud and abuse can be committed by providers, suppliers, plan members and administrators and can be sophisticated or quite simplistic. The end result is higher plan costs and/or reduced coverage options. To reduce risk, employers must keep benefits information secure, never sign blank claims forms, assure that practitioners are licensed, report suspicious behavior and scrutinize the accuracy of claim statements. Employers should also educate plan members about the effects of fraud. Commonly abused services can be limited, and claim audits can uncover abuses.
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Retiree Benefits Class Action Against the Ontario Government Certified.
Hull, Leanne; Canadian Legal & Legislative Benefits Reporter; v22 no1 pp 6-8 Feb 2004; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : As of August 28, 1974, retirees from the civil service of Ontario were eligible to receive postretirement dental and health benefits from the government of Ontario. However, changes were made in June 2002 that significantly reduced the postretirement benefits due to the retirees. As a result, the retirees filed a class proceeding claiming that the reduction of benefits was a violation of the retirees' Section 15 rights under the Charter of Rights and Freedoms. The Ontario Superior Court of Justice reviewed the statutory requirements for certifying the action as a class proceeding and found that each requirement of the Class Proceedings Act was met. Therefore, the retirees can proceed with their class action claim against the government of Ontario.
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The Changing World of Ancillary Benefits.
Taylor, Anne Chalupa; Employee Benefits Journal; v28 no2 pp 32-34 Jun 2003; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Steadily rising health care costs have forced some employers to reevaluate their benefit packages and consider adding ancillary benefits. These benefits include dental, life insurance, long term disability, vision coverage, employee assistance plans, work/life balance products, group legal, Section 125 plans and more. Ancillary benefits can be funded by the employer, employee or both. They contribute to job satisfaction and can play a critical role in recruitment and minimizing employee turnover.
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A Review of Dental Plans: PPOs and Referral Plans to Dominate Future.
Boe, Thomas L.; Davis, Elaine; Employee Benefits Journal; v28 no2 pp 36-39 Jun 2003; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : There is a wide variety of dental plans employers can choose from when offering dental benefits to employees. Indemnity plans and dental health maintenance organizations (DHMOs) are being used by employees less as they opt for PPOs and referral plans. Referral plans, also known as access plans, are not actual insurance plans, but instead offer third party referrals to dental care at a reduced rate in exchange for a monthly fee. Employers also have the option of establishing self-funded dental plans for employees. These plans reimburse the employee for money spent on treatment instead of basing reimbursement amounts on the type of care received. Employers may also choose to establish medical expense accounts, dental expense reimbursement plans, or medical savings accounts in order to reduce dental costs.
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District Court Denies Defendant's Motion for Summary Judgment in Dispute Over Benefits for Jaw Surgery.
Legal-Legislative Reporter; v37 no2 p 9 Feb 2003; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The plaintiff underwent a complex and expensive jaw surgery for which she received preapproval for payment of the procedure and certification that the surgery was medically necessary from the defendant; however, the precertification letter also contained a statement that precertification did not guarantee claim payment. After the defendant only paid a small portion of the surgery bill on grounds that the plaintiff had reached her maximum lifetime benefit for the procedure, the plaintiff filed suit. The defendant asserted that the plaintiff did not appeal her benefit decision in a timely manner and thus failed to exhaust her administrative remedies and also that it had discretionary power to review and decide the plaintiff's claim and that its classification of the surgery as being related to temporomandibular joint syndrome was correct. The court found that the plaintiff did indeed exercise her administrative remedies and that the defendant abused its administrative discretion.
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