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If you're a Illinois small business employer, you should understand the different types of dental plans available to determine the best option for you and your employees.
Like health insurance plans, dental insurance plans are usually categorized as either 'indemnity' or 'managed care' plans (Dental PPO plans fit in this latter category). Put broadly, the major differences concern choice of dental care providers, out-of-pocket costs and how bills are paid. Typically, indemnity plans offer a broader selection of dental care providers than managed care plans. Indemnity plans pay their share of the costs for covered services only after they receive a bill (which means that patients may have to pay up front and then obtain reimbursement from the insurance company).
Managed-care plans typically maintain dental provider networks. Dentists participating in a network agree to perform services for patients at pre-negotiated rates and usually submit the claim to the dental insurance company directly. In general, patients have less paperwork and lower out-of-pocket costs with a managed-care dental plan and a broader choice of dentists with an Indemnity plan.
In 2010, the President signed into law the Patient Protection and Affordable Care Act, which includes special federal tax credits for small businesses in Illinois offering dental insurance to employees. The credit is only available for tax years 2010-2013 and is designed to make health insurance benefits more affordable for small business owners before health reform is fully implemented in 2014.
The federal tax credit will reimburse qualifying small businesses in Illinois for up to 35% of the premiums they pay towards employee dental insurance. Tax-exempt organizations may qualify for a tax credit of up to 25%. To qualify for the full credit, the following criteria must be met:
Illinois small businesses with 10 or less full-time employees that pay average annual wages of $25,000 or less may qualify for the full credit. The amount of the credit is reduced for companies with more full-time workers and higher wages, until it is phased out entirely for those with 25 or more full-time workers and average annual wages over $50,000.
Because eligibility rules are based in part on the number of full-time employees, not the total number of all employees, Illinois small businesses that use part-time help may qualify even if they employ more than 25 individuals.