Premium Rates

• The goal for all insurance premiums is to be affordable to the customer, so neither individual nor group dental insurance plans should be cost-prohibitive to most people. Nonetheless, the premium rates can vary. When you participate in a group dental plan through your employer, there is a possibility that your employer will pay your premium for you in whole or in part. Any portion of the premium that you can offset to another party is more money in your pocket. You must pay the entire premium for an individual plan yourself.
  
  

Adverse Selection

• Adverse selection is a term used by insurers to describe a risk pool that is skewed too far in any direction. When a large pool of people buy benefits through a group plan, the risk of adverse selection is minimized because there will likely be people who claim many benefits and also those who don't use their policies at all. The group balances itself out. By contrast, individual plans have no such risk control. Insurers must price individual plans to account for the potential of adverse selection, so you may end up paying a higher premium than your particular risk level warrants.
  
  

Waiting Period

• Typically, the only waiting period for a group plan is the time set by your employer before you are eligible to buy the insurance. Once you begin paying premiums, you usually have access to the full range of benefits immediately. This is not true with individual plans. To prevent against consumers only buying dental insurance when they need major dental work, individual plans often come with waiting periods of six months or more, sometimes up to two or three years. During this time, you can claim routine cleanings and x-rays, but major work like root canals are often off-limits.
  
  

DMOs and PPOs

• A dental maintenance organization (DMO) requires you to choose a single dental practice to handle all your needs. This practice then refers you to others as your circumstances demand. A preferred provider organization (PPO) allows you a broad range of in-network and out-of-network providers from which to choose for dental services. DMOs and PPOs are available for both group and individual policies. DMOs tend to provide greater benefits than PPOs, but are more restrictive about the providers you can use to receive services.