In this episode, Ben Tuinei will talk about the types of dental plans and non-covered service laws. He explores the distinctions between self-funded and fully insured plans, discussing the financial implications for employers and patients. Ben explains how self-funded plans fall under federal ERISA laws, while fully insured plans are governed by state regulations. He addresses the challenges dentists face in navigating these conflicting laws and offers insights into patient advocacy. Additionally, he guides how individuals can determine if their state has non-covered service laws and where to seek legal counsel for interpretation.

Time stamps

  • 00:01:15 – Can you briefly explain the different types of dental plans that exist? 
  • 00:03:19 – What laws govern these plans?  
  • 00:04:13 – When it comes to each state’s non-covered service, are self-funded dental plans truly exempt from those state law stipulations? 
  • 00:07:02 –  What advice do you have for those who are being bullied by insurance plans on non-covered service issues? 
  • 00:09:15 – How do I find out if I’m in a state that has a non-covered service law? 

Resources

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