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My Dental Bene昀椀ts Delta Dental www.deltadentalins.com • 800-521-2651 Diagnostic and Preventive Care Services will no longer Choose a PPO Dentist to Save! accrue towards your plan year maximums. This includes The dental plan allows a participant to visit any licensed x-rays, cleanings and exams. dentist, but by taking advantage of the nationwide PPO Proper dental care plays an important role in your overall network you will maximize the value of the plan. You can good health. Our Dental Plan is designed to encourage search the Delta Dental PPO Network for a dentist near preventive treatment, allowing team members to achieve you by visiting http://www.deltadentalins.com/dentist- oral health while striving to minimize dental costs. The Dental directory/ppo.html. Plan will be administered by Delta Dental. Enrolled team members will also have access to hearing aid discounts. Delta Dental Delta Dental Non-Delta ® PPO Premier Dental 1. Greater Savings 4. Avoid Unbundling PPO dentists have agreed to reduce fees, which PPO dentists agree to not unbundle services that are part leaves more money in your pocket. of a treatment. Out-of-Network dentists may charge for these services separately, making the overall cost higher. 2. Quality Assurance 5. Less Paperwork Delta monitors PPO dentists to ensure that proper licensing, cleanliness and safety procedures are followed PPO dentists handle all claim forms and other paperwork for and send regular updates on policies and contracting you. If you choose an out-of-network dentist, you may be requirements. required to submit the claim yourself. 3. No Balance Billing 6. No Prepayment Required PPO dentists cannot charge you more than their set When you choose a PPO dentist, you will pay only your fees. Out-of-Network dentists may bill the difference portion of the bill. Out-of-Network dentists may require you between their usual feel and Delta Dental’s contracted to pay up front and request a reimbursement from Delta rate — a process known as “balance billing”. Dental when the claim is submitted. Note While you may seek services covered under the Dental Plan from any dentist, you will have access to discounted pricing when utilizing the PPO network dentists. 35

Team Member Guide to Benefit Enrollment - Page 35 Team Member Guide to Benefit Enrollment Page 34 Page 36