Designed for Dental Savings

Inflated dental care costs may lead employers to believe they must provide richer dental benefits to keep employees happy.

But what if that increases their healthcare spending? Consider a dental plan design that’s more appropriate for employees, not just more.

“Dental plans should increase savings, not spending,” says Jake Bendler, division vice president of strategic partners and distribution at Ameritas. “Understanding the causes of overspending helps create smarter, more sustainable plans.”

Plan Design Can Prompt Provider Behavior

Dental insurance can influence how care is delivered. For example, the number of periapical X-rays per patient has nearly doubled over the past decade for those with employer-sponsored plans that cover them at 100% (preventive), the 2025 Ameritas Dental Insurance Market Report found. Ameritas data shows the use of periapical X-rays is far less common when covered at 50% (major) through an individual plan.

“This increased utilization per patient leads to overall increased paid claims per group, which eventually drives up premium costs,” Bendler says. Ameritas data shows higher utilization of periapical X-rays can increase premium no less than 1% for affected groups. 

To control costs, Bendler advises, move periapical coverage to major (50%). If periapicals are needed for diagnostics, they will be available at the same coverage level as the treatment, such as a crown or implant. Bitewing X-rays typically performed during routine visits have frequency limits and are covered at 100%.

Rightsizing Annual Maximums

Dental annual maximums are steadily rising. The National Association of Dental Plans consistently reports annual maximum benefit levels trending higher over time, with 65% of plans offering $1,500 and higher annual maximums in 2024.

“An annual maximum that exceeds a group’s actual needs will not only raise premiums but actually encourage discretionary spending,” Bendler says. “On the other hand, maximums set too low can lead to delayed care and more costly services in the long run.”

Maximums should be based on a group’s demographics and expected use of dental services, not market averages or competitive pressures. As Bendler explains it, younger groups, families, and older adults have very different usage patterns. Aligning maximums to those needs helps prevent over-insuring while still protecting members from financial risk.

Misaligned Procedure Categorization

Categorization of procedures directly impacts usage and cost. In general, routine preventive care that is fully covered includes the most widely used services and makes up the largest portion of plan-paid costs. Meanwhile, more costly and less frequently used procedures such as crowns account for the largest share of member out-of-pocket costs. Consider both the frequency and cost impact of services like gum disease treatment (periodontal care) and focus on preventive care to manage costs.

“You might not think of perio as preventive care,” Bendler says, “but if the plan design makes periodontal care accessible, that supports early intervention for better dental and overall health.” It also reduces the likelihood of more expensive treatment in the future. And covering higher-cost restorative procedures at lower coinsurance levels—for example, 50% rather than 80%—controls premiums without eliminating coverage.

Designing Benefits for Stability

While richer dental benefits might be the most common response to increasing dental care costs, poorly designed plans can unintentionally encourage overspending. A smarter approach supports prevention, guides appropriate use, and makes costs predictable and sustainable for employers and employees.

“At Ameritas, we believe dental benefits should do more than pay claims,” Bendler says. “They should improve long-term health outcomes while helping employers manage sustainable costs. The goal isn’t to reduce access, but to align benefits with the care employees are most likely to need and value.”