Employers considering dropping dental from benefits plan should think twice: expert

One reason for employers to reconsider dropping dental coverage is that they don’t actually know their employees’ total household income, he says.

Read: Enhanced national dental plan to require reporting of employer-provided coverage: budget

“I do see a lot of employers that, if their employees’ incomes are under that threshold and they’re single, I see them thinking about [dropping coverage] for sure. The reality is [with] most businesses, if there’s a comparable offering and somebody else is paying for it, they’re going to take a hard look at that option.”

The first phase of the plan was launched in December 2022, which saw coverage of up to $650 per year for children aged 12 and younger, as well as eligible seniors aged 87 and up. Earlier this year, the program opened up to eligible seniors aged 71 to 86, children age 18 and younger, people with disabilities and eligible seniors aged 65 to 69. All remaining eligible Canadians will be able to apply starting in 2025.

But the federal government’s new national dental care program has a few hurdles to clear before being implemented fully across the country, he says, noting while the general idea of a national program is positive, a lack of consultation with key stakeholders has led to some confusion and issues getting dentists on board. “We want people to have dental care [and] it was a good idea to make it complementary to private coverage because there [are] a lot of people even in retirement that have their own personal plan, for example. I think the issue for me is the devil is in the details.”

Indeed, Young notes that during the program’s initial rollout, many Canadians mistakenly thought they had access to free dental care, not understanding that they may not actually qualify for the free program because of their family income bracket.

Read: Employers pausing benefits plan redesigns amid talk of national dental, pharmacare programs

In terms of employers dropping coverage, he doesn’t expect to see more established organizations pursue this path once they fully understand the details. “It’s just their core plans in front of them. But we’re definitely getting asked that question. I think it’s not going to hit until next year because the bulk of our employee population won’t be eligible for coverage until 2025.”

Another issue is that plan members’ own dentists may not have signed up for the program. The federal program introduced a reduced fee guide for dentists, relative to what they could charge patients through a private plan, he says, adding dentists will want to avoid scenarios where patients may be subject to a copay due to their income threshold, which they maybe didn’t anticipate and can’t afford.

“[Dentists] may be concerned that they might have to either do something creatively with that copay or help [patients figure out how they’re] going to collect that balance. . . . They’re being forced into a cost model they maybe didn’t agree to. . . . While it has good intentions, . . . I think maybe [the government] just rolled it out without enough consultation.”

Young believes industries with low-income workers will benefit most from the national plan — if more dentists sign on. While it may affect some union negotiations, he notes many unionized workers won’t meet the income threshold, particularly if they have two-income households. “It’s really going to be those niche industries [with] lower earners. For example, I wouldn’t be surprised if some fast food chains that offer benefits to their employees [may drop coverage] when there’s probably a large amount of [employees] that are . . . single-income earners.”

Read: Dental-care program’s employer reporting requirement may cause barriers to care: experts