How to offer SHOP dental insurance

There are 2 ways to offer SHOP dental insurance:

  • As part of a coverage offer that includes a SHOP health insurance plan
  • By itself, without a SHOP health insurance plan

Some SHOP plans include dental benefits. If you pick a health plan that includes dental coverage, you don’t need to take any of the actions below. Offering dental coverage is optional.

Talk to your insurance company or agent or broker to find out more about SHOP dental plans.

2 dental plan categories: High & low

The category of dental plan you choose affects how much your employees pay for dental premiums, deductibles and copayments, and the total yearly amount they’d have to spend out-of-pocket.

The categories have nothing to do with quality of care. They're based on how the insurance company and your employees share the costs of care:

  • Low: The dental plan pays about 70% of the total costs of dental care. The employee pays about 30%.
  • High: The dental plan pays about 85% of the total costs of dental care. The employee pays about 15%.

Employee choice of dental plans

You can choose to offer one dental plan to your employees, or you can select a plan category — low or high — and let your employees choose any dental plan available in that category.

Paying part of your employees' dental premium

As with health plans, you can choose how much of an employee's dental premium you pay. You don’t have to pay any of it.

If you offer your employees a choice of dental plans, your contribution will be applied to the cost of whatever dental plan the employee picks.


More Answers: SHOP dental coverage

If I offer dental coverage to employees, can their dependents enroll in it?

If you offer dependent coverage with a health plan, employees can choose to enroll their dependents in the health plan only, health and dental plans together, or just the dental plan. Employees must enroll in a dental plan before their dependents can enroll. If an employee enrolls in health and dental coverage, their dependents can enroll in a dental plan without enrolling in a health plan.

Do I have to offer pediatric dental coverage to my employees' children?

No. You can offer dental coverage to your employees and, if you like, to their dependents. But you don't have to.