Dollar - based plans (often referred to as Direct Reimbursement / Direct Assignment plans) are freedom of choice, self-funded, dollar-based, fee-for-service dental plans. The difference between these types of plans and self-insured plans are that their reimbursement is based on cost, not procedures.

Under a DR plan, the covered person pays the dentist’s charges and files a receipt with his or her employer or a plan administrator for reimbursement. There is no insurance carrier. The plan then reimburses on a dollar tier level which is based on a percentage of total cost of the dental treatment.

Under a DA plan, the dentist agrees to have the plan administrator reimburse up to plan limits and then balance bills the covered individual that portion of the fee not paid by the plan. DR and DA plans are group dental plans offered by employers.

In Florida, Pelican Dental Concepts offers self-funded, dollar-based dental plans based on freedom of choice (of dentist) and fee for service. They include Direct Assignment, Direct Reimbursement and Direct Assignment Plus plans.

The Florida Dental Association endorses Pelican Dental Concepts for groups with 20 or more employees. Please visit the Pelican Dental Concepts web site for more details.