[Locke]

Originally Posted by Northendzone

^ in the context of group insurance, dental premium rates are generally set by taking the claims paid for a period of time (usually 12 months), adding in an allowance for the plan administration expenses (this would include a profit margin for the insurance company) and then adding in an allowance for future expected inflation (I.e the fee guide going up).

Generally speaking there are maximums built within the plan that are set at the request of the policyholder. The higher these limits the more expensive the plan can become, because claims will increase due to the higher maximums

Generally speaking, most employers have a group benefits consultant advising them . The consultant would independently review the historical claims data to determine if the premium rates are appropriate. In addition, the consultant would review the plan design and provide the client with comments on the maximums relative to the marketplace which would include peer companies as well.

The insurance companies have developed their own fee guide, called the reasonable and customary which defines the amount they will pay for a particular dental code.

As a complete aside, I read in the paper this week that the dental association was meeting in jasper this week and that the dental fee guide was not going to be a part of their formal discussions.

Ahhh Actuaries....Accountants who couldnt stand the excitement.