Most dental insurance plans have proven either too costly or too restrictive for Carole A. Gudde's 50-employee Riverside company, Archive Management Service Inc.

After much research, she is pondering a self-funded dental benefit plan through Peelle Financial & Insurance Services in San Diego. And she may look into the state's first licensed discount dental card program.

First Dental Health in San Diego plans to sell its New Dental Choice discount card to small businesses and the uninsured beginning Nov. 1. The card is the state's first licensed discount health card since the Department of Managed Health Care began pressing for them in 2004.

The New Dental Choice card will cost $8 a month for individuals and $10 a month for families after a one-time $15 administrative fee. Card carriers will present the card to dentists in First Dental Health's network and receive 25% to 50% off full prices. The discounts apply to about 300 dental procedures including fillings, braces, crowns, teeth whitening and other cosmetic treatments often not covered by traditional insurance.

For example, a First Dental network dentist will accept the card for a reduced price of $650 for a crown immediately after the patient signs up for the program. The patient will pay the reduced rate plus the monthly fee that totals $96 to $120 a year. An individual traditional insurance plan may cost $480 the first year, after which coverage kicks in for a crown that typically costs about $900. The patient would have to pay about half that procedure cost plus the first year's premiums, said Michael Grossman, First Dental's founder, president and chief executive officer.

First Dental has 8,000 dentists in its California network including approximately 1,000 dentists in Riverside and San Bernardino counties. Patients, called subscribers, can search for dentists by location and specialty on the First Dental Web site.

Photo By Dan Elliott Dentist Dexter Dejesus, left, Edith Cabriales and Jeanene Mullins at Desert Dental Group and Specialty in Victorville.

First Dental will offer price breaks for businesses that purchase cards in bulk for their employees, Grossman said. Price reductions will be decided on a case-by-case basis, he said.

Whether Gudde buys in to the discount program depends in part on the quality of dentists in the program's network, she said. Gudde is vice president and co-owner of Archive Management.

Redlands Blueprint and Commercial Printing Co. provides Kaiser Permanente health insurance for some of its nine employees, but no dental coverage.

"Most of those plans are far too expensive for us," said Irene Bashiu, co-owner. The business has never used discount cards for dental care and Bashiu was unaware of the New Dental Choice card coming out in November.

California has 19.4 million people covered by commercial dental benefits, according to the National Association of Dental Plans in Dallas, Texas.

Discount dental plans comprised only 8% of nationwide dental plan enrollment this year, according to the association. Direct reimbursement comprised 1% of the market, while dentist preferred provider organization, or PPO plans, comprised the lion's share at 49%.

Of companies with 500 to 999 employees, 89% offered dental coverage in 2005. Of those with 250 to 499 employees, 85% offered dental benefits, while 79% of companies with 100 to 249 workers provided coverage.

Of businesses with 50 to 99 workers, 68% provided benefits last year while 61% of businesses with 25 to 49 workers provided dental plans. Only 40% of businesses with six to 24 employees offered dental coverage, according to the dental plan association.

Dental plan premiums rose 2.7% this year and fell 1% last year, the association said. In 2003 and 2004 premiums rose a respective 4.2% and 5.2%.

Network dentists who accept the discount card will make up revenue through increased patient volumes, Grossman said.

Desert Dental Group operates five dental offices in Victorville, Hesperia and Apple Valley. All of its dentists are providers for the First Dental Health network. Group dentists accept other discount cards through Affordable Family Services, Premiere Access and Golden West, said Christine Loveridge, administrative assistant at Desert Dental Group and Specialty in Victorville.

Dentists enter contracts for reduced rates to draw a broader pool of customers, Loveridge said. The office has three dentists and treats about 200 patients a week. About 25% are sponsored by employer insurance, Loveridge said.

Desert Dental has not yet received information about the new First Dental Health discount card. The company "is having big expectations for New Dental Choice because it's the first licensed plan," she said.

"We haven't seen a whole lot of patients with the previous card," Loveridge said.

First Dental introduced a discount card called The Dental Club in 2001. It was the precursor to the New Dental Choice card. The regulatory environment at the time was unsettled and a license was not required, Grossman said. The company did not advertise the card beyond its Web site.

First Dental plans to expand its business in the fast-growing Inland Empire, Grossman said. The company will market the card to businesses and enlist brokers to reach them, he said.

"The Inland Empire is an area we're focusing on," he said. The discount card will be the company's first major foay selling directly to consumers and businesses. First Dental typically contracts its network of dentists to insurance companies. Its insurance clients include PacifiCare, Nippon Life and Principal Financial. A total of about 8,000 workers and their dependents at the County of Riverside offices, Morongo Casino, Pala Band of Mission Indians and Agua Caliente casinos and tribes use the First Dental network through insurance plans.

The discount card targets 15 million people in California who have no dental coverage, Grossman said.

The California Department of Managed Health Care licenses health plans and health discount products. The department since 2004 has issued seven cease-and-desist orders after consumers complained.