September 24, 2024
Our enhanced dental experience, launched in 2024, delivers a higher standard of care through an expanded provider network—nearly 100,000 unique providers nationwide—with comprehensive coverage, affordable coinsurance and no out-of-pocket expenses for in-network preventive services.
And since good oral health is critical to overall physical health, beginning in 2025, our medical and dental plans will work together through Dental4Health, our program that proactively delivers extra preventive oral treatment and care management support to employees with certain medical conditions. Dental4Health, embedded in fully insured plans and available as a buy-up for ASO groups, helps improve employees’ oral and physical health and lowers their cost of care.
Now, thanks to your feedback, we’re making it even easier for more groups to offer Asuris Dental benefits. The following dental waiver and participation updates will apply to all 2025 new and renewal effective dates:
- Waivers accepted: We’ll accept waivers for other qualifying dental coverage and will exclude employees with valid waivers from the participation calculation.
- Revised participation guidelines:
Voluntary: Employer contributes less than 50% to the employee rate | Employer-paid: Employer contributes 50% or more to the employee rate |
Groups with 1-3 eligible employees: 100% must enroll after consideration of valid waivers. | Groups with 1-3 (2-3 in Idaho) eligible employees: 100% must enroll after consideration of valid waivers. |
Groups with 4+ eligible employees: At least 50% must enroll after consideration of valid waivers. | Groups with 4+ eligible employees: At least 70% must enroll after consideration of valid waivers. |
These changes will take effect for new and renewing groups beginning with Jan. 1, 2025, effective dates. There are no changes to dental waiver and participation rules for 2024.
We're excited to implement these updates to further improve our enhanced dental experience for your groups and their employees.
Questions? Please contact your account representative. We're here to help and look forward to supporting you in 2025.