Dental Insurance United Concordia

February APRIL 2010 Dental Insurance  Eligibility is determined based on where an employee lives.  Regular Option – available in all areas.  PPO Option – available in Metro Atlanta, Augusta, Columbus, Macon, Valdosta, Savannah  Prepaid Option – available in Metro Atlanta

February APRIL 2010 Dental Benefits Comparison Regular PPOPrepaid 100% * 100%100% 80% * 90% 100% 50% * 50% 60%* 50% * 50% 50%* Dependents Dependents Employee & under 19 under 19 all eligible dependents Preventive Basic Major Orthodontia * Of the 90 th percentile Employees may use a PPO provider even if enrolled in the Regular Dental Option. This may result in lower out-of-pocket costs

February APRIL 2010 Dental Service Categories  Type I (Preventive) Cleanings, Oral Exams, X-rays  Type II (Basic) Fillings, Root Canals, Extractions, Scaling, and Root Planing  Type III (Major) Crowns, Bridgework, Periodontal Surgery For the Regular & PPO Dental options:  Preventive or Type I services (e.g. Oral Exams, Cleanings, and X-rays) are excluded from the $1,000 annual maximum  Increases the annual maximum available for Basic and Major services during the year

February APRIL 2010 Dental Benefit Provisions Regular & PPO Annual Deductible$50 per person; $150 family (for Basic & Major services) Maximum $1,000 per person per plan year (for Basic & Major services) $1,500 lifetime benefit for Ortho Waiting Period* New employees or newly enrolled dependents – Major & Ortho Late Entrant Limitations** Current employees enrolling for 1 st time Basic, Major, & Ortho *After 6 months continuous coverage **After 12 months continuous coverage for Basic & after 24 months continuous coverage for Major & Ortho

February APRIL 2010 Dental Regular & PPO Late Entrant Limitations  Applies to: Current employees enrolling for first time or re-enrolling after discontinuing coverage Employees who do not enroll when first eligible Employees who fail to pay premiums when on leave without pay  Not Apply to: Employees transferring between dental options Employees enrolling when first eligible Employees enrolling due to qualifying change in status

February APRIL 2010 Prepaid DHMO (CIGNA)  No claim forms to complete  No dollar maximums  No deductibles  No late entrant limitations  No waiting periods  Budgetable Dental Care: all patient charges listed on Patient Schedule Charge

February APRIL 2010 Prepaid DHMO Reminders  You must see a Network Dentist to receive benefits  You must complete and submit a Dental Selection Form  An individual may change their Network Dentist by contacting CIGNA Customer Service Department toll free  If the change request occurs by the 15 th of the month, the change will be effective the first day of the following month. After the 15 th, the change will be effective the first day of the second following month