1. Choice
Plus
Dental
Good oral hygiene and regular dental care is important throughout your life.
This Presentation is for training purposes only – See policy for complete benefit description

2. Choice
Plus
Dental
  Introducing a new type of “hybrid” dental insurance policy that combines traditional fully insured benefits with PPO discount pricing.

3. Dental Choice Plus Freedom of Choice
Unlike many PPO plans that will not pay anything if you go outside their network, Dental Choice Plus will pay the non-network provider at the same rate as if they were in network.
Your client will only be responsible for the non-network charges that are in excess of the pre-negotiated network fee schedule.

4. Dental Choice Plus Employer Sponsored Plan Individual Dental Plan
In addition to the key benefits list for individual plans, employer sponsored plans are available.
Available for groups of 3 or more
$25 application fee is waived
List Bill eApplication enrollment
Rates for ages 65+
No waiting periods on Diagnostic and Preventive care benefits.
Diagnostic & Preventive paid at 100% when using a network provider.
Two plan options to choose from with Calendar Year Maximums benefits of either $1,500 or $2,000.
Over 169,000 access points across the United States.
eApplication enrollment

5. Dental Choice Plus Benefits
Reimbursement Method In/Out
Standard Plan Pays**
Yr. 1 / Yr. 2 / Yr. 3+
Enhanced Plan Pays**
Diagnostic & Preventative
No Wait
100% / 100% / 100%
Basic (Filings & Simple Extraction)
Basic
6 months
50% / 65% / 80%
Endodontic
Major
0%* / 25% / 50%
Periodontics
Oral Surgery
Restorations
Orthodontics
Prosthodontics
Co-Pay (Per Person, Per Visit) No more than 3 per person per calendar year
$25 Thru age $40 over age 65
$25 Thru age $40 over age 65
Insurance Calendar Year Maximum per person per calendar year
$1,500
$2,000
Orthodontic and Prosthodontics Lifetime Maximum ($1,000 Lifetime Max, Limited to $350 per Calendar Yr.)
$1,000
* Insured pays only the discounted pre-negotiated network provider rate.
**Annual coinsurance amounts are based on policy years.
$25 Application Fee For Individual Applications. Application Fees are waived for employer sponsored plans

6. Choice
Plus
Dental
Good oral hygiene and regular dental care is important throughout your life
Given the suspected link between periodontitis and systemic health problems, prevention is the first step to maintain good long-term health.
Dental Choice Plus is economical because it focuses on benefits you need…not benefits you may never use.
Diagnostic & Preventive Services are paid at 100% with only a $25 co-pay when using a network provider. No waiting periods or deductibles.

7. Diagnostic & Preventative Services paid at 100% No Waiting Periods
Choice
Plus
Dental
Dental Choice Plus focuses on providing the benefits you need to maintain good oral health at affordable prices
Diagnostic & Preventative Services paid at 100% No Waiting Periods
Examples of Diagnostic & Preventive Services when receiving benefits through PPO
Waiting Periods
Amount Paid
Routine oral exams - 1 exam per 6 month period
No Waiting Period
100%
Bitewing X-rays (up to a set of 4) - 1 set per Calendar Year
Full Mouth X-rays (Panoramic Film or Full Series) - no less than 36 months apart
Prophylaxis (cleaning and scaling of teeth) - 1 per Calendar Year
Topical application of Fluoride for dependent children under per Calendar Year
Consultation - other than treating doctor
Comprehensive Oral Exam
Sealant - dependents under 14, one treatment per tooth no less than 36 months apart
Space Maintainers - the initial appliance for dependent children under 13, including adjustments within the 6 month period immediately following installation

8. Care PPO Schedule
CI-3
The schedule applies to services provide by a participating General Dentist and is an extensive list of most common procedures. The purpose of this schedule is to establish the maximum fee that a General Dentist will charge for each listed procedure . Fee schedules are determined by the zip code of the participating provider. Participating Specialists do not charge according to this fee schedule but will give a 20% discount.

9. Choice
Plus
Dental
If the annual calendar year maximum benefit is exhausted, you can still take advantage of the pre-negotiated network provider’s fee schedule as long as you use a participating network provider.
With over 169,000 access points across the United States Care PPO
pre-negotiated fee schedule will apply to give continued savings even after the insured benefits are exhausted.
If you go to a participating network provider who resides in a higher cost area we will pay based on the point of service provider at no additional cost.

10. Area Rating Factors Based Three Digit Zip Code
Choice
Plus
Dental
Area Rating Factors Based Three Digit Zip Code
State
Zip
Area
Alabama
Florida
Indiana
Mississippi
All 3 4 6 2
Arizona
323 5
392
Iowa
393
Arkansas
329
Kansas  
California
332 7
660
Missouri
900 9
Kentucky  
652
938 8
939
Georgia  
Louisiana  
Nebraska
940
941
311
Nevada
312
961
891
399
Michigan  
893
957
Illinois
958
600
897
959
485
898
960
605
New Mexico 10
Colorado
North Carolina
629
499
State
Zip
Area
Ohio
Pennsylvania
Texas 3
182
763 6
797 10
435 4
764
186
765
885
766 5
Utah
442
767 7 2
193
768 8
769
Virginia
454
South Carolina
770
201
290
772
Oklahoma
223
All
293
775
294
Tennessee
West Virginia
370
788
157
789
Wisconsin
158
790
791
537 9
167
733
792
538
793
539
178
794
179
759
795
Wyoming
796

11. Choice
Plus
Dental
Rates Are Based On Resident Zip Code Area Child Only Rates Are Not Available
Standard ($1,500 Annual Benefit)
Area 2 3 4 5 6 7 8 9 10
Individual
17.30
18.40
19.50
20.70
22.00
23.40
24.90
26.40
28.00
Individual +Spouse
31.40
33.40
35.50
37.70
40.10
42.60
45.30
48.20
51.20
Individual + Child(ren)
32.30
34.30
36.50
38.70
41.20
43.80
46.50
49.50
52.60
Family
47.50
50.60
53.80
57.10
60.80
64.60
68.70
73.00
77.70
Enhanced ($2,000 Annual Benefit)
19.40
20.60
21.90
23.20
24.70
26.20
27.90
29.60
31.50
35.40
40.00
42.50
45.20
48.10
51.10
54.30
57.80
Individual + Child(ren)
36.30
38.60
41.10
43.60
46.40
49.30
52.40
55.70
59.30
53.60
57.00
60.60
64.40
68.50
72.90
77.50
82.40
87.60
$25 Application Fee For Individual Applications. Application Fees are waived for list bill business with 3 or more employees.

12. www.careington.com/co/PAL AMERICAN PHILADELPHIA
LIFE INSURANCE COMPANYSM

13. PHILADELPHIA
AMERICAN
LIFE INSURANCE COMPANYSM
Provider Search

14. PHILADELPHIA
AMERICAN
LIFE INSURANCE COMPANYSM
Provider Search

15. PHILADELPHIA
AMERICAN
LIFE INSURANCE COMPANYSM
Provider Search

16. Provider Search Results For 75070
PHILADELPHIA
AMERICAN
LIFE INSURANCE COMPANYSM
Provider Search Results For 75070
Step 4

17. AMERICAN www.careington.com/co/PAL PHILADELPHIA Administered by:
LIFE INSURANCE COMPANYSM
Administered by:
Careington International Corporation
7400 Gaylord Parkway
Frisco, TX 75034

18. Dental Choice Plus State Approvals
PHILADELPHIA
AMERICAN
LIFE INSURANCE COMPANYSM
Dental Choice Plus State Approvals VT WA ME MT ND MN OR WI NY ID SD MI WY PA IA OH NV NE IL IN WV AK UT VA CO CA KS MO KY NC TN OK SC AZ NM AR AL GA MS TX LA HI FL
3_14

19. Choice
Plus
Dental
  Finally, a dental policy that covers the services you want at a price you can afford.