we're going to talk about uh at this point uh the concept of deductibles and co- insurance and this is specifically under your group uh plan Group Health Plan uh most times we see this under dental plans where in fact we have dental coverage under our group or employee uh plan our extended Health Plan and under our dental plans they tend to be a deductible and Insurance type of coverage so let's spend a bit of time uh trying to make sure you're clear on what a deductible and co- Insurance actually means so deductibles are a dollar amount and in many dental plans uh you'll have an individual or or and a family deductible this is the annual amount that you must pay upfront before or you can uh put through a claim so the first for example if we have a $100 deductible plan that means the first $100 of expenses you have to pay out of your own pocket any additional expenses after that will then be covered by the plan subject to co- Insurance um percentages and we'll talk about that uh in a moment or two so individual deductible in other words you are going to pay the first $100 you may have plans that also have a family deductible so a lot of plans will have $100 individual deductible and a $250 family deductible so if the first member of the family goes to the dentist and incurs a bill of uh $200 the first $100 is they're going to have to pay out of their pocket uh because that's that individual deductible if then second family member goes to the dentist and again they may incur a charge of $220 they are going to also have to pay the first $100 so that individual that second individual will pay $100 now let's say the third individual could be the children they go to the dentist and they incur a bill of $190 uh in that scenario there's only going to be a $50 deductible apply because during the year that family would have paid $200 for the first two people but the third person the child going to their to the uh dentist uh will only incur a $50 deductible because the family deductible is $250 so once that $250 threshold is met there is not going to be any additional deductible applicable to that family anyone in the family for the rest of that year so make sure you are understand the difference between an individual deductible and a family deductible now second uh concept here is co Insurance deductibles are a dollar amount Co insurance is a percentage and so a CO Insurance says after we've paid our deductible how much is the insurance company going to cover of the balance and so many plans have a 8020 uh Co insurance or 7520 5 what that means is that your insurance company will cover 80% of the balance you have to pay 20% of that balance so when asked to calculate a repayment you're going to see questions uh likely in your uh tests uh where they're saying here's a scenario please let me know or let us know how much the client can expect as a refund from this Dental expense that they've had and so you need to make sure you know how to do the calculation remember the first thing you do is you you take off the deductible so you pay all the deductibles and then after that you apply the co- Insurance percent there are some examples in your book I'd make sure that you're familiar with that uh how their deductibles and Co Insurance are applied in a specific family situation so if here's an example that hopefully will help you uh let's have a sample plan where the individual deductibles are $100 per individual the family deductible $250 and Co Insurance 8020 that means 80% of the balance is going to be paid by the insurer 20% paid by the insured so that's a sample plan and you can uh run through the calculation