Your district’s claims information is now available because of PA 106. Now is an ideal time for you to review your dental and vision claims experience from the last three years to determine if self-funding is a viable option.

Why self-fund?

• Self-funding can eliminate 8 to 10 percent of typical insurance company costs because you pay only claims costs, not premium. Dental and vision programs are traditionally low risk for school districts because they control their exposure through benefit design.
• SET Employee Benefits suggests you request your three-year history from your current dental and vision insurance carriers. Comparing the cost of claims to premiums paid can help you determine whether self-funding is viable.

What you pay

With self-funded plans, you are responsible for paying the cost of benefits, a per person, per month fee for a third-party administrator (TPA) and a network access fee if you add a network to your plan. In most cases, these combined costs are lower than you would pay in premium.

The network advantage

Many districts that self-fund add a dental or vision network to help reduce the costs of claims.

Dental networks

• Participating dentists agree to accept lower fees for service.
• Network discounts can reduce claim costs by an average of 20 to 30 percent.
• The strength of these networks varies throughout the state. Some regions have a higher population of in-network dentists. Your district should review a list of providers before selecting a participating network.
• Dental networks include American Dental Network and DenteMax. Although both charge network fees, generally access costs are low compared to the claims savings.

Vision networks

• Districts can implement a benefit payment schedule and assign costs for each type of service available to employees.
• Vision networks include United Healthcare Vision and Vision Care Direct. Both networks have developed special plans available through SET Employee Benefits for self-funded or fully insured plans.

SET Employee Benefits is a TPA for self-insured plans. We also offer fully insured dental and vision plans for districts not interested in self-funding.

Call your SET SEG Account Executive for a competitive bid today!