How does it work?
The plan operates as a simple reimbursement plan. The employee/dependent visits the dentist of their choice and receives the necessary treatment. The employee will then submit a claim accompanied with itemized documentation to Navia for approval. Once approved, the employee is reimbursed for their dental or vision expense based on their plan design.
A Direct Reimbursement Plan is a self-funded alternative to employer sponsored dental or vision insurance. The plan uses a consistent reimbursement structure for expenses using only the cost of the service as the determining factor. The Direct Reimbursement Plan concept is a simple, cost effective way to provide a dental or vision plan that will meet the employer’s financial goals and the employee’s benefit needs.
Direct Reimbursement Plans are simple, cost effective, and guarantee the following benefits:
- Virtually all funds go toward dental treatment (90% – 95%) – not to extraneous overhead or administration.
- No Networks! Employees are free to visit any dentist they choose, including their current dentist.
- Plan flexibility – Employees will be happy with decreased plan restrictions
- No premiums! Instead payment is made when actual treatment is received.
Direct Reimbursement Plans can be customized to fit your company’s needs. During the setup process, we will assist in customizing every aspect of the plan’s design including the reimbursement structure, total benefit allotment, and disbursement schedule. The plan design below is just one example of an employer wishing to offer a tiered reimbursement structure that totals a potential $1200 benefit to its employees.
- 100% reimbursement on the first $300 of expenses, then
- 80% reimbursement on the next $500 of expenses, then
- 50% reimbursement on the next $1000 of expenses
What expenses are eligible?
Depending on which plan you’re offering, any dental or vision expense under the scope of IRC Sec 213d can be reimbursed. If you’re planning on offering the dental portion of the benefit, you will determine if orthodontic expenses will be reimbursable under your plan.
The only expenses that would not be covered are procedures that are purely cosmetic in nature (i.e.teeth whitening, veneers, non-prescription sunglasses, etc.)
Your employees will have access to the top tools and resources available without any additional costs. The services listed below are included for your participants as part of our standard administration.
- The MyNavia Mobile App
- Online Account Access
- Online Claim Submission
- Account Statements
- Direct Deposit or Direct Check Mailing
As our Client, we’ll provide you with the best features available in the industry at no additional cost to you or your employees. The services listed below are included as part of our standard plan administration.
- Customized Plan Designs and Materials
- Online Account Access and Eligibility reporting
- Dedicated Account Team
- Custom Reimbursement Cycle
- Integration with Payroll and HRIS systems
- Plan Document & SPD Preparation
- Secure File Uploads
- Annual Non-Discrimination Testing (NDT) and Form 5500 Preparation
- Compliance Support Services
Interested in learning more?
Contact our sales team at 425.452.3498 or email@example.com