Self-Funded Dental & Vision Plans

ASi offers several Self-Funded Dental and Vision plans for your clients to choose from as part of their complete benefits package.  Our Self-Funded Dental and Vision plans are customizable and tailored to fit your client’s needs and financial goals.

ASi’s flexible managed dental and vision fee for service programs have proven to be cost effective alternatives to traditional dental and vision insurance plans. Employers who self-fund dental and vision benefits usually save 35% or more than on traditional dental and vision insurance premiums.

How Self-Funded Dental & Vision Plans Work

With our Dental and Vision plans, you completely fund all dental and vision claims for their employees.  However, you have the freedom to design and tailor the benefit plan to what fits your company’s needs the best. Most employers design their plan to include a share of costs arrangement with their employees.

Share of Costs – A share of costs is a concept that allows employers to make employees financially responsible for a portion of their benefit plan.  For example, if the benefit amount per employee is $100, your client could design a share of cost plan of 50/50, where they would pay 50% of the $100 and their employee would pay 50% of the $100. That means they would both owe $50.

Self-funded dental and vision plans allow an employer to only pay for claims that are actually incurred. Under traditional fully insured dental and vision plans, an employer must pay premiums for a participating employee even if they do not use the plan.

These plans can implement claims being paid based on Usual, Customary and Reasonable (UCR) fees. Under this scenario, the benefits paid will be restricted to a certain UCR percentile chosen by you. This protects you from paying claims to providers whose fees are higher than UCR.

STEP 1

  • You decide if you will offer either dental, vision, or both plans. You set a contribution allowance limit, design the plan, and determine reimbursable expenses.

STEP 2

  • Enrolled employees see provider for healthcare services. Provider will submit claim to ASi or require upfront payment.

STEP 3

  • ASi will process the claim and request claim funding amount from you. You will send funds to ASi. ASi will then send money to pay the claim.

STEP 4

  • ASi will send provider/employee an Explanation of Benefits with final amount the employee is responsible for. Employee will pay provider any remaining employee responsibility.

ASi Dental Plans

With our dental plans, we offer several different networks to choose from to give your employees a bigger discount when seeing a contracted dental provider. Below are the networks you can choose from:

The plan participants will receive an ASi Benefit ID Card that they will provide to their dental provider. They can choose to go to a contracted or non-contracted provider. However, if they choose to go to a non-contracted provider, their out-of-pocket costs will be more than if they went to a contracted provider.

ASi Vision Plans

With our vision plans, we do not offer a network. The participants will receive an ASi Benefit ID Card and they can go to any provider to receive vision services. Some vision providers choose to require payment up front for services, which means your employees will have to pay out-of-pocket upfront and then submit an itemized statement to ASi for reimbursement.

What Expenses Are Eligible?

Since you have the freedom to tailor dental and vision plans to fit their needs, eligible expenses are determined by the employer. We are happy to help guide you in the best direction to satisfy their company’s needs.

Employer Features

You become part of the ASi family, which means providing them with the best features within the industry. The features listed below are included as part of our administrative services.

  • Cost Savings
  • Customizable Benefit Plans and Materials
  • Plans comparable or equivalent to traditional benefit plans
  • Assist in Plan Design, Including Plan Design Options and Features
  • Draft Plan Documents, Including the Basic Plan Document, Adoption Agreement, and Summary Plan Description
  • Dedicated ASi Teams Who Provide Personalized Customer Service
  • Assist in Group Enrollment
  • Provide Participant ID Cards (if applicable) and Plan Materials
  • Marketing Materials for Your Employees
  • Timely Claims Processing
  • Provide Standard Reports Upon Request
  • Provide Annual Plan Review

Participant Features

We know your employees are the heart of their business, which means we provide them with great tools and resources to help them manage their benefits.

  • Member Benefit ID Card
  • Easy to Understand Benefits Breakdown
  • Contracted Providers and/or Flexibility to See Any Provider

How is Enrollment Handled?

We can provide an Excel census form (for onboarding and open enrollments), as well as, enrollment forms for you or your Human Resources department to complete. We also will help in-person during your open enrollment event if requested.

What Can I Expect from ASi?

  • Personalized Customer Service
  • Assist in Plan Design, Including Plan Design Options and Features
  • Draft Plan Documents, Including the Basic Plan Document, Adoption Agreement, and Summary Plan Description
  • Assist Broker in Plan Presentation
  • Assist in Group Enrollment
  • Provide Participant ID Cards (if applicable) and Plan Materials
  • Marketing Materials for Your Employees
  • Provide Claims Procedures
  • Timely Claims Processing
  • Provide Standard Reports Upon Request
  • Provide Annual Plan Review

Still Have Questions?

Check out our FAQs or contact us!

Want to Know More About these Services?

Contact our Sales team
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Phone: 866-777-1320 or 559-256-1320
Email: salesteam@asibenefits.com