Do dental benefits roll over from year to year?

Preferred provider organization – or PPO – dental plans will come with annual maximums, which are exactly what they sound like: the total amount of money a plan pays for covered dental services in a benefit year. If a member were to exceed the threshold, they’d have to pay for any remaining services out of pocket.

That said, many people do not meet their annual maximum. So, what happens to it? Is that money just gone? Depending on the policy, some of the money may “roll over” to the following year, which means a member will have more dollars at their disposal for future dental procedures. Let’s break down how this works.

What is a rollover policy?

Each year, a dental plan covers a certain dollar amount in claims (how much depends on the specific plan). With a few of Beam’s ancillary employee benefits plans, when less than half of the annual maximum is used, a portion of it will “roll over” to the next year. This means it’s added to the following year’s annual maximum, providing more flexibility to pay for dental care.

What does a member have to do? Nothing! Beam’s rollover will occur automatically at the beginning of the next plan period as long as it’s received at least one covered dental service (e.g., dental cleaning) during the current benefit year.*

How might the rollover work?

Let’s use an example. Say a plan’s annual maximum is $1,000, but only $200 is used in claims that year. A member would be eligible for a rollover because less than half ($500) was used. Beam will take one-fourth of the annual maximum and add it to the following year — in this case, that’s $250. Next year’s annual maximum would now be $1,250, assuming the same plan is kept.

Rollover amounts can accumulate over multiple benefit years. If a member were to again use less than half of the annual maximum next year, they would be eligible for another rollover the following year. They’d get another $250 added to the annual maximum, bringing it to $1,500 (annual max + this year’s rollover + next year’s rollover). However, these cumulative rollovers are eventually capped when they reach a certain amount, which would depend on the plan.

Here are some examples of what that may look like: