State-based pricing for dental PPO takes effect in 2021

June 09, 2020

The cost for PPO dental coverage will transition to state-based pricing beginning in 2021, to be more competitive with the actual cost of dental care in local communities.

The cost of dental coverage, similar to medical coverage, varies throughout the country. To ensure that Board of Pensions offerings align with the local, state-based price of care, beginning in 2021, the cost of PPO dental coverage will be adjusted to reflect local costs. (The DMO, if available to employees, will continue to offer flat rates in 2021.)

All 50 states, plus the District of Columbia and Puerto Rico, have been assigned to one of five groups, established by Aetna, based on similar average dental costs for PPO coverage. The employer’s location will determine its group. Due to the variability of average costs, the states in each group may not be adjacent.

Employers will see their costs for 2021 dental coverage when they log on to Benefits Connect to create their Employer Agreement in July 20. Many employers will see lower rates in 2021. For those who experience increases, the cost of coverage will not increase more than $10 per month at any level. The dental benefit rate checker, which provides a monthly estimate of the cost of coverage, will also reflect the new PPO pricing when annual enrollment for members begins on October 26, 2020.

Robust benefits

There are no changes to the comprehensive benefits offered by the Dental Plan for 2021. It continues to offer 100 percent coverage for preventive and diagnostic care, such as routine checkups and cleanings. The plan also provides generous benefits for basic services, such as fillings and simple extractions; major services, such as prosthodontics (including implants), bridges, and crowns; and orthodontic treatment for eligible dependent children.

If you do not currently offer dental coverage, learn more about the Dental Plan and consider offering it to your employees in 2021. You may offer dental coverage to any employee — regardless of the number of regularly scheduled work hours. Employers may, but are not required to, contribute toward the cost of dental coverage.

If you have questions about dental coverage or selecting benefits for your employees, call the Board of Pensions at 800-773-7752 (800-PRESPLAN).