Vision benefits continue to grow in popularity among employees and demand for them remains high in today’s competitive labor market. With more screen time, aging workforces, and increased attention to overall wellness, eye care has moved beyond a “nice to have” and become an essential part of competitive benefits strategies. As employers look to differentiate their benefits packages while maintaining cost control, consultants play an important role in guiding them toward the right vision solution. The challenge is that group vision insurance is no longer a one-size-fits-all product. There are many plan designs, network options, funding structures, and combinations to consider.

Whether you’re working with a small business offering its first vision plan or a larger employer reevaluating current coverage, understanding how to navigate these choices can help you deliver long-term value and client satisfaction.

Matching plan design to employee needs

The first step in choosing a vision plan is understanding the needs of the employee population. Ask:

• Do employees or dependents wear corrective lenses?
• Are regular eye exams a high priority?
• Is there interest in elective procedures like LASIK or access to non-prescription eyewear?

For example, a group with a high proportion of families may benefit from broader materials coverage to account for multiple dependents needing glasses or contact lenses. If employees are mostly younger professionals who prioritize digital eye strain prevention or fashionable frames, a plan with strong allowances and retail access might be more appealing.

Some plans focus on exams only, while others offer materials-only coverage or comprehensive benefits that include both. Understanding which services employees are most likely to use makes it easier to recommend a plan that meets expectations without unnecessary overspend.

Why network access matters

The strength and scope of a network can greatly affect the employee experience. For example, with Ameritas, access to top national networks like VSP and EyeMed gives members the freedom to choose from both independent providers and popular retail chains including Target Optical®, LensCrafters®, and Visionworks®. This flexibility supports ease of access, which supports higher utilization and satisfaction.

Some clients may prefer the simplicity of a no-network plan, where employees can see any provider and receive the same benefit regardless of location. Others may want the added savings and negotiated discounts that come with a network-based plan. It’s worth reviewing providers and considering the geographic distribution of employees when evaluating options. A strong network strategy supports employee convenience and cost efficiency.

Cost structures and funding approaches

Vision plans can be structured with different benefit frequencies, frame and contact lens allowances, and cost-sharing features like copays or deductibles. For employers, affordability is often the primary concern, but it shouldn’t only be about premiums. It’s also about balancing what the plan covers with what employees will realistically use and minimizing out-of-pocket expenses.

Many small and midsize employers benefit from set-rate, fully insured plans with simplified pricing and easy administration. Larger groups may qualify for more customized rates or multi-tiered plans that offer different levels of coverage under one umbrella. Some plans allow for dual or triple choice designs, giving employees the ability to select the plan that best fits their needs and budget during enrollment. This approach offers greater flexibility without increasing administrative complexity.

Integrated and add-on options

Employers are increasingly interested in ways to enhance value without significantly raising costs. That’s where combination plans and add-on features come into the conversation. For example, vision can sometimes be integrated with dental benefits through a shared maximum model, allowing members to use a portion of their dental benefit for vision services. Other plans offer the option to add exam coverage to an existing dental plan or include a benefit reward program that encourages utilization and increases available benefits in the future without increasing premium. These options can also streamline administration for employers. For consultants, helping clients uncover these opportunities can reinforce your role as a benefits expert.

Vision benefits and long-term value

The best vision plan is one that aligns with a client’s budget, administrative capacity, and employee needs — now and in the future. A well-designed plan supports preventive care, encourages regular eye exams, and makes it easy for members to access providers and use their benefits. This approach may lead to healthier outcomes, higher engagement, and increased loyalty to the employer.

As you guide clients through plan selection, consider how the plan will perform over time. Plans that prioritize network access, strong coverage for materials, and options for customization are more likely to meet evolving needs and contribute to employee well-being. Additionally, pairing vision with dental or other benefits can simplify processes and drive stronger results.

Employers and employees can reduce medical expenses by integrating dental care into overall health management. Research shows that individuals receiving regular dental care can experience significantly lower medical costs, particularly those with chronic conditions like diabetes and coronary artery disease. These findings highlight the growing importance of dental benefits in integrated health strategies.

Read this white paper to discover how consultants are best equipped to provide solutions and value when data is paired with perspective.

When helping clients build a dental benefits strategy, one of the most important and often overlooked decisions is how the plan is funded. As costs continue to rise and employers become more focused on long-term value, comparing self-funded vs. fully insured models is key. Each funding mechanism offers unique advantages, and choosing the right one depends on the organization’s size, financial goals, and risk tolerance.

Fully insured: predictable and simplified

Fully insured dental plans offer employers the security of a fixed monthly premium. The insurance carrier assumes the financial risk for claims, so whether usage is high or low in a given year, the employer cost stays the same. This model is often favored by smaller or risk-averse organizations looking for budgeting predictability and administrative simplicity. Built-in services like claims processing, compliance oversight and customer support are typically bundled into the plan.

However, this predictability comes with trade-offs. Premiums are priced based on projected claims and include margins for carrier risk, overhead, and profit, meaning employers may pay for coverage they don’t use.

Self-funded: flexibility and control

Self-funded arrangements are gaining traction, especially among larger employers. According to market insights, over 30% of all groups with more than 500 lives now use a self-funded dental model. The drivers behind this shift include cost containment, cash flow control and the ability to customize benefits more effectively for their workforce.

In this model, employers pay for actual claims as they occur, while the insurance carrier or third-party administrator handles the administrative side: processing claims, managing the network, and ensuring compliance. This gives employers greater flexibility in plan design and deeper visibility into how the plan is being used.

The power of data transparency

Self-funded plans may also unlock powerful data insights, a growing priority for employers focused on overall health outcomes. Ameritas partners with population health companies to use medical insights, connecting dental benefits to overall health outcomes. This may help identify early patterns, such as connections between periodontal disease and chronic health conditions like diabetes or cardiovascular issues. This transparency isn’t just about seeing the data; it’s about acting on it. With advanced tools and partnerships, employers can make more proactive decisions that improve both health outcomes and cost efficiency over time.

Helping clients choose the right fit

No single funding model is right for every client. When guiding employers through this decision, it’s important to consider:

• Size of the employee base: Larger organizations may typically be better suited for self-funded models due to more predictable claims trends. Smaller employers may prefer the stability of fully insured plans.
• Risk tolerance: Self-funded plans come with variability. Employers who are comfortable with financial risk and want to avoid paying for unused services may favor self-funding. Fully insured plans offer consistent monthly costs.
• Cash flow needs: If predictable budgeting is a top priority, fully insured may be more appropriate. Self-funding provides long-term savings potential but requires managing month-to-month claim variability.
• Administrative capacity: Self-funded plans often require more oversight. Employers with limited HR resources may lean toward fully insured options where most services are handled by the carrier.

Your role as a strategic advisor

As the benefits landscape evolves, consultants have an opportunity to go beyond quoting and become strategic funding partners. By understanding client goals and helping them weigh the pros and cons of each funding model, you can guide them toward a solution that fits both their budget and their long-term vision for employee health. For a deeper dive into trends and data insights driving funding strategy shifts, review the 2024 Ameritas Dental Market Report.

Americans today, on average, live longer than previous generations. If your senior clients live to age 65, the Centers for Disease Control and Prevention projects they’ll live another 19.6 years. Without a dental plan, seniors may have to dip into their retirement savings or use a credit card to pay dental costs.

As adults age, they often deal with the frustrations of unexpected medical issues. Common concerns are arthritis, cancer, diabetes, respiratory problems and obesity. After a lifetime of caring for their teeth, seniors are concerned about maintaining good dental health. Share these four dental plan solutions.

Dental in a Medicare plan 

Since original Medicare plans do not cover routine dental exams, your senior clients may want to consider a Medicare Advantage plan. This plan option usually covers twice-a-year dental exams and cleanings. However, there may be restrictions on accepted dental providers or no-network savings options. A Medicare Advantage plan may offer limited help for other dental procedures, such as fillings, crowns, bridges or implants. Seniors will typically need to pay these expenses out of pocket.

Dental discount plan 

Another option for senior clients is a dental discount plan, sometimes called a dental savings plan. A dental discount plan is not insurance but a type of membership plan. Members pay an annual fee instead of a monthly premium. They receive a dental discount card and visit a participating dentist to receive lower dental costs. But some dentists may not accept the discount card.

Advise your clients to check with their dental provider to ensure they accept discount cards and offer lower rates on dental procedures before considering this option.

Employer-sponsored dental coverage

Seniors who continue to work full time usually keep their employer-sponsored dental benefits for as long as possible. Employers tend to offer different types of dental coverage:

• Preferred Provider Organization (PPO) – This option provides members access to an extensive network of dental providers. PPO plans promote in-network dentists for the most savings because network providers agree to charge a reduced amount for covered dental procedures. Out-of-network benefits can vary.
• Dental Health Maintenance Organization (DHMO) – DHMO dentists are paid monthly in return for providing their DHMO patients with covered dental services at no or low cost. Sometimes, a DHMO plan price is lower than a PPO plan. However, members can only visit a dentist in the approved network to receive coverage for dental care.
• Indemnity insurance plan – Members can see any dentist and receive coverage with a traditional indemnity dental plan. These plans may cost more, but the benefits may be worth it. Members pay costs not covered by the plan at the dentist’s usual fee.

Individual dental plan

Most seniors plan to keep working past age 65. But changes in work status may change their eligibility for employer-sponsored dental benefits. If you have senior clients in this situation, help them find the right individual dental plan.

With individual dental insurance, seniors will have coverage when they need it. They can immediately use the plan for preventive care and basic procedures. Major expenses, such as crowns, bridges or root canals may have a waiting period. Most plans also include access to dental network providers for added savings.

The cost of individual dental insurance is a relatively low monthly fee. It provides good value in terms of cost savings. Plus, seniors will have the security of knowing their plan will help pay for fillings, crowns and root canals. By scheduling regular preventive dental visits, seniors can avoid costly procedures or catch them early.

Help educate your clients on their dental plan options in retirement.

Inflation is causing your clients’ employees to evaluate spending decisions. About 40% of Americans have cut back on expenses, including spending on benefits and healthcare services. As employees become more concerned about inflation and recession, they look to employers for help. But employers often wonder what they can do. Here are four ideas on how to help your clients ease workers’ inflation concerns.

Thought leaders are people or companies who offer advice and ideas based on their expertise in a specific area. In the realm of senior dental and vision insurance, authentic thought leaders play a critical role in shaping industry trends, offering valuable insights, and driving innovation. Here are four ways to find authentic thought leaders on senior dental and vision benefits.

Identify their reliable expertise

Dental and vision insurance thought leaders should have a deep background in health benefits. Choose experts who assess the market needs and identify choices that provide the right health options for senior employees or retirees.

Thought leaders’ influence extends well beyond their own organizations. They’re frequently sought after for their opinions, leading to collaborations, speaking engagements, and publications.

Thought leaders often have extensive experience acquired through years of research, practice, and collaboration. They stay updated on the latest developments, attend industry conferences, and actively engage with those in their target demographics, keeping them at the forefront of industry trends. Their expertise is valued, making them influential figures in shaping the future of senior dental and vision insurance.

Focus on original thinking and research

In the health benefits field, many thought leaders repeat the same ideas for every audience and every situation. But often these ideas don’t work. Businesses and individual clients want advice and insights that fit their specific problem.

Work with experts who have first-hand knowledge with access to original or recent primary and secondary research. They should use this information to identify trends and develop industry applications. For example, those looking to reach seniors with benefits should rely on benefits carriers who research what seniors want.

Authentic thought leaders also should analyze the information to show understanding, drawing upon their expertise to help with senior health benefit needs. The advice should be original and appropriate to each situation.

Engage through events and connections

Find and attend industry events and conferences on senior dental and vision benefits to connect with and learn from industry leaders.

Another way to connect is to find experts through social media channels, newsletters and blogs. Subscribing to thought leaders’ newsletters or blogs is an excellent way to receive regular updates and stay up to date with the latest trends.

Look for accurate solutions

When evaluating thought leaders, research their track record for effectiveness and accuracy of the advice and recommendations they’ve previously given. Did their recommendations fit the needs? Was the advice on target? For those that followed the thought leaders’ advice, how did it affect their success and benefits? If their solutions to benefits issues work for your clients, that thought leader may have strategies and solutions for you.

Ameritas: An authentic thought leader

Ameritas is a long-term trusted thought leader in dental and vision benefits, including benefits for seniors. Ameritas leaders regularly speak at national conferences to educate business leaders, brokers, consultants and agents in the latest trends with employee benefits and communication strategies.

Seniors want access to the voluntary vision and dental benefits that will assist them in keeping their teeth and eyes healthy as they age. Ameritas can provide group plans that meet the needs of diverse employee groups from young employees just out of college to tenured senior employees. Individual plan designs are created with seniors in mind. We understand the needs of seniors within group plans and those purchasing individual coverage in retirement.

Learn about more Primestar® individual dental and vision coverage.

Today’s consumers are accustomed to a personalized shopping experience. Brands they buy from frequently reach out to them suggesting products they might like. This can drive sales by presenting shoppers with additional options.

These consumers also are your clients’ employees. And they’re looking to their employers to offer a similar shopping experience in the form of customized benefits. Benefits that fit their specific needs and life goals. Because competition for talented workers is growing, it’s vital for your clients to offer the benefits employees want and need.

Especially benefits like dental and vision, which easily can be tailored to fit employees’ (and employers’) needs.

This infographic highlights five questions to ask employees to find out what they expect from their dental and vision plans. Personalized benefits increase employee satisfaction, engagement and retention. It helps you retain clients, too.

Dental and vision are among the most widely used benefits. But even the most comprehensive benefits packages don’t deliver if employees don’t understand what benefits they have and how to use them. For dental insurance open enrollment, provide materials educating employees on their benefit options and how the plans work.

Work with a dental and vision carrier that can help you provide a robust enrollment experience for your clients and their employees. Increased education and awareness of their benefits can increase employee participation and plan usage. And you’re more likely to retain clients.

It’s important to customize enrollment support so it fits your client’s specific needs. If clients are not sure what enrollment materials to offer, you can suggest options to help them meet their goals. Here are some materials a dental and vision benefits carrier can offer for a successful enrollment:

Library of digital brochures on benefits topics

Benefits can be hard to explain and understand. Use brochures to give a high-level look at benefits. If there is more than one plan offered, an enrollment booklet could include tips for how to choose a plan based on the employee’s needs. Help educate employees about all aspects of the benefits being offered, like:

• procedure cost estimates
• network provider savings
• incentives or rewards plans

Customized benefits website

The site should outline plan details and may offer FAQs and forms to help employees through the enrollment process. Employees can refer to the site year-round for plan details.

If clients maintain and prefer to use their own branded benefits enrollment booklets or websites, the carrier should provide benefits content that fits the client’s needs. This plan content should be concise and easily incorporated into their materials.

Customized benefits videos

Videos make it easy for employees to learn about plan details and choices.

If they’re hoping to increase dental enrollment and their employee base is broad and in multiple locations, offer to provide a simple video that outlines their dental plan options, costs and health advantages of having dental benefits. Your client can feature it on their employee website or in an employee email newsletter.

Ask questions and focus on the client’s goals

Start by understanding your client’s benefits and business goals. Are they trying to increase plan enrollment, use of benefits, or use of network providers?

Once you know your client’s big picture goals, ask some questions to find out what types of enrollment support fit best.

Does your client:

1. have a website that’s dedicated to employee benefits?
2. promote benefits on an employee website?
3. share benefits information through an employee newsletter or email?
4. Host an in-person or online benefits fair?
5. perform employee benefits enrollment online or on paper?
6. use online benefit enrollment/administration platforms?

These questions will start conversations that allow you to help your clients accomplish their benefits and business goals.

Be your clients’ trusted benefits adviser by working with the benefits carrier to create educational benefits materials.

As seniors start thinking about retirement, many worry about maintaining good health. They can get medical coverage through Medicare and gap insurance but wonder about insurance coverage for dental needs. Most have taken care of their teeth and want to maintain them for quality of life.

Several Medicare Advantage plans offer coverage for basic dental needs, but many people need more oral care. Stand-alone dental insurance is a better option, especially for seniors. Here’s how you can help your senior clients find the dental coverage they need.

1. Identify dental needs

When discussing dental coverage with clients, ask several questions to help them evaluate their oral health needs:

• Do they need annual or bi-annual exams for a professional cleaning and checkup?
• Do their teeth and gums hurt or bleed?
• Do they have teeth with crowns or root canals?

These answers can help you identify the dental coverage each person needs. It’s important to know, because poor gum health and tooth decay increase the risk of developing heart disease and pneumonia. The Centers for Disease Control and Prevention report that about 60% of adults 65 and older have gum disease.

2. Review plan options

Original Medicare plans do not cover routine dental and vision exams. But some Medicare Advantage plans typically cover dental exams and professional dental cleanings twice a year. However, these plans may have a restricted dental provider network or no network savings. There also may be limitations on coverage, such as fillings, crowns and implants.

Many retirees change Medicare plans each year. When making this change, they lose the benefits they had with their previous Medicare health plan. The new Medicare plan may have new usage restrictions for dental. This won’t happen with a stand-alone individual insurance plan.

In addition, an individual stand-alone dental plan offers more robust benefits that may better meet your client’s needs. As mentioned, seniors and retirees keep their dental benefits with stand-alone dental, even if they change Medicare plans, because they are separate.

Insurance providers like Ameritas also don’t coordinate coverage; they treat all stand-alone individual dental claims as the primary claim. This way, there is no reduction in benefits if your clients have another Medicare Advantage plan.

Stand-alone dental insurance provides seniors and retirees peace of mind. It helps cover costs for exams, professional cleanings and services that help maintain healthy teeth.

Additional plan features to know:

• Coverage levels – Depending on the plan, basic or major dental services for fillings, crowns and root canals are covered at different levels. There may be a deductible or coinsurance amount associated with some services. Ensure your clients understand how the different coverage levels work.
• Annual benefit amount – Most dental plans have an annual benefit maximum for covered services and procedures. Knowing this amount will help clients manage procedure costs and avoid unexpected bills. For example, by safely timing necessary dental work, retirees can maximize each year’s annual maximum benefit.
• Waiting periods – Some dental plans have a waiting period of up to 12 months for more expensive services. However, some individual stand-alone dental plans, such as through Ameritas, offer day-one benefits for many services (especially preventive care). That means members can use their coverage once they’ve paid the premium.
• Network providers – Some dental plans offer access to a dental provider network, so it’s easier for your clients to find a network dentist and receive network savings. In-network doctors and specialists agree to accept a set payment from the insurance company for each covered service. If retirees use an out-of-network dentist, the insurance plan usually covers less of the cost. So it pays to find out if a client’s dentist or specialist is in the dental plan’s network or not.

3. Insurance carrier reputation

When reviewing dental insurance coverage, you and your clients will want to check the reputation of the carrier providing the coverage.

• Ask other agents for recommendations.
• Find out whether current customers are satisfied with the insurance company.
• How many people stayed with the carrier after the first year?
• How long has the carrier been in business and how fast are claims paid?
• Is it an established, financially strong company? This information can often be found on the insurance carrier’s website or social media.

Sources and References:
Centers for Disease Control and Prevention

Budget constraints and economic uncertainties may be causing your clients to evaluate their benefits options, such as dental coverage. Do they need dental insurance? Or would a discount dental plan suffice? Both options can help pay for dental procedures. But one design may be a better choice. Here’s what you should know about dental insurance vs. a discount dental plan.

Dental insurance

For those with employer-sponsored coverage, research shows employees today expect that dental insurance is automatically included in their benefits packages. Many employers cover most of the monthly premium. Or, they may offer access to a quality voluntary dental insurance plan. Retired individuals, or those not eligible for coverage through an employer, can purchase an individual plan online.

Dental insurance benefits usually feature two preventive exams each year. Most plans cover 100% of the cost. A dental exam includes a professional cleaning with routine X-rays – depending on the plan design. It includes a wellness check of the teeth and gums. Plus, the dentist examines the oral tissues, looking for signs of medical conditions the patient may not know about.

Dental insurance coverage helps pay for the cost of other dental procedures at different levels, such as basic services like fillings being covered up to 80%. Major dental services such as a crown, root canal or extraction could be covered up to 50%. The plan member is responsible for the remainder of the billed fee.

Patients with dental insurance that includes a nationwide PPO network of dental providers could save an average of 25% – 50% by visiting a network provider. In addition, why not offer a dental plan backed by a reputable insurance carrier offering perks, such as the dental cost estimator tool provided by Ameritas?

Types of dental insurance plans

According to the American Dental Association, there are many dental insurance plans to choose from:

Preferred Provider Organization (PPO) – This option features the benefits of a traditional plan with access to an extensive network of dental providers. PPO plans promote in-network dentists for the most savings because network providers agree to charge a reduced amount for covered dental procedures. Plan members can receive coverage with any provider. Out-of-network benefits can vary. These plans have an annual maximum benefit, reflecting a yearly amount available for dental services.

Dental Health Maintenance Organization (DHMO) – DHMO dentists are paid monthly in return for providing their DHMO patients covered dental services at no or low cost. In some cases, the price for a DHMO plan is lower than for a PPO plan. But members can only visit a dentist in the approved network to receive coverage for dental care.

Discount dental (not technically insurance) – With discount dental, members usually pay a monthly or yearly membership fee. In return, they receive discounts on common dental care services from a specific network of dental providers. These providers also may receive or charge a flat, discounted fee for each dental service they perform. Also known as a dental savings plan, discount dental may be ok in the short term for healthy individuals who don’t require much dental care.

Indemnity insurance plan – Members can see any dentist and receive coverage with a traditional indemnity dental plan. These plans may cost more, but the benefits may be worth it. Members pay costs not covered by the plan at the dentist’s usual fee.

Other dental plans

There are direct-reimbursement plans, point-of-service plans, other limited network plans and scheduled benefit plans. If you work with a carrier offering these types of plans, ask for clarification on the benefits so you can help your clients decide what works best for them.

Remember, dental plans have an annual renewal. So if your clients want to change dental plans or choose a different dental insurance carrier, or both, they can find a new plan that meets their evolving needs.