Alberta plan sponsors, members continue to face pressures despite new dental fee guide

With the new Alberta dental fee guide taking effect on Jan. 1, 2018, many plan sponsors will likely be taking a look at their benefits plans to consider the impact of the changes on them.

The new fee guide provides for an 8.5 per cent cut in suggested prices for 60 common procedures. Most plan sponsors will take their lead from the insurers on administering the new fee guide, says Brian Lindenberg, a senior partner at Mercer in Calgary. While Alberta dental fees will still be high, he believes the 8.5 per cent reduction in suggested prices is positive and notes most insurers will be gearing up to implement it. However, since it’s a voluntary guide, it’s uncertain whether dentists will actually accept it, he adds.

Read: Alberta touts 8.5% price cut under updated dental fee guide

“So there’s a risk, if you will, that the dentists say no . . .,” says Lindenberg. “In which case, there is the potential for an individual to be out of pocket relative to the fee guide more so than if the dentist had implemented it. Although my sense of the rule is that most dentists will probably fall into line with the suggested fee schedule . . . there’s always the danger, always the risk . . . that a dentist will say, ‘You know what? I’m going to continue to charge a higher fee.’” 

Read: How do Alberta’s dental fees compare to other provinces?

Alberta Blue Cross, one of the largest payers of dental services in the province, said in a statement it welcomes action to bring the province’s dental costs in line with the rest of Canada. But it also said that, even with the reduction in fees, Alberta’s costs are still higher than the rest of the country, a situation it suggested is making dental coverage unsustainable for plan sponsors and members.

Alberta Blue Cross said it would review the new fee guide to determine any adjustments needed for Jan. 1.

In the case of plan members in Alberta, they’ll have to exercise smart consumer behaviour and shop around, says Darcy Smith, president of Benefit Consultants Inc. in Edmonton. “The consumer still has to take a role in this process, even though the human behaviour is such that they don’t, generally, because the bill is being paid through a program.”

Elizabeth Harris, a benefits advisor at HB Consultants in Calgary, agrees. “The consumer really has to check. When they go to the dentist, ask them, ‘Are you following the new fee guide? Are you charging above the new fee guide?’ Because it’s like getting your car fixed. You can get very different quotes everywhere you go.”

Read: Consumerism, prevention key to countering Alberta’s high dental fees

However, Alberta-based consultant Gord Simle doesn’t feel plan members will necessarily put in the extra effort. In fact, he believes they’re better off driving to a neighbouring province for real savings. “If you’re really smart or if you’ve really got the time . . . find a dentist in one of the neighbouring provinces and plan your holidays around your dental treatment,” says Simle. “Take a day off and go. You’ll save 30 per cent doing that.”

As for the fee guide itself, he notes it’s a reference point. “It’ll be added to the reference points they already have. And trusting in the insurers’ typical way of handling things, whichever one gets them the lowest cost of reimbursement is the one they’ll probably use. And they’ll leave it up to the plan member on how to cover the rest.”