Pelican Defined : Create Your Own Dental Plan
What Are the Pelican Dental Concepts?
The key words are self and direct. Pelican Dental Concepts is based on self-funding and direct connection of employer, employee, and dentist. Self-funding gives employers total control of costs because they tailor the contribution, funding, and benefit structures appropriate for their business. Claims administration is easy due to the dollar-based plan design of direct reimbursement (DR), direct assignment (DA), or direct assignment plus (DA+).
- The employer sets an annual maximum benefit in dollars for each participant. Benefit payments are a percentage of the dentist's fee. Here is one sample from almost unlimited options.
Sample Plan of Covered Costs
100% of the first $200
80% of the next $1,000
annual maximum: $1,000
The benefits are not based on the type of procedure.
More plan designs - The employee chooses any licensed dentist. Together, they create a treatment plan.
- After a visit, the patient or dentist files a simple claim.
- Payment is swift: about 10 days.
- Unused benefit dollars remain in the fund.