Lincoln Intermediate Unit #12Your Delta Dental Benefits Plan

Who is Delta Dental?

#1 provider of dental benefits in the United States

Covers over 51 million members; 93,000 groups nationwide

The first organization designed to provide group dental benefits – still our one and only specialty

Three out of four dentists nationally participate

Local offices in Mechanicsburg, PA

The Delta Dental Advantage

Largest dentist network in the U.S.• 3 out of 4 dentists participate with Delta Dental

Freedom of choice with Delta Dental PPO plus Premier• Select any dentist you want, but save more money by choosing a Delta Dental dentist

User-Friendly Service: Call toll-free (800-932-0783) every business day, 8 a.m. to 8 p.m.

(EST)

Visit Delta Dental online at: www.deltadentalins.com

Quality Control• Delta Dental makes sure the care you receive is necessary and

effective

The Delta Dental Advantage

Lower Out-Of-Pocket Costs• Delta Dental’s allowances mean lower costs to you

• Delta Dental dentists will not charge any more than applicable copayments and deductibles for covered services

Claims Convenience• Delta Dental dentists submit claim forms for you and Delta Dental

pays the dentist directly

Quick Claims Processing• Delta Dental typically processes claims in 10 calendar days or less

Delta Dental PPO plus Premier

LIU has access to combined networks of participating dentists who participate in Delta Dental PPO and Delta Dental Premier networks

You have complete freedom to choose:

A dentist who participates in Delta Dental PPO Premier network or

A dentist who does not participate with Delta Dental

Savings are determined by your choice

LIU Dental Benefits

Delta Dental effective January 1, 2009

Same LIU dental plan

No need to re-enroll

ID cards Each enrollee will receive two dental cards

Additional cards from Delta Dental’s web site, www.deltadentalins.com

ID card is not required to receive treatment – your dentist simply calls Delta Dental to confirm eligibility

LIU Dental Plan Delta Dental PPO plus Premier

*Note: Percentages are based on applicable Delta Dental allowances.

Covered Benefit

Delta Dental Premier Dentist

Non-Participating Dentist

Paid by Delta Dental*

Paid by Patient* Paid by Delta Dental*

Paid by Patient*

Diagnostic (Exams and x-rays) 100% 0% 100% 0%

Preventive (Cleanings, sealants, space maintainers, fluoride treatments)

100% 0% 100% 0%

Basic Restorative (Fillings) 100% 0% 100% 0%

Oral Surgery (Extractions) 80% 20% 80% 20%

Endodontics (Root canal therapy) 100% 0% 100% 0%

Periodontics (Surgical & non-surgical treatment of gum disorders)

80% 20% 80% 20%

Major Restorative (Inlays, onlays, crowns) 80% 20% 80% 20%

Prosthodontics (Construction and repair of fixed bridges, partial or complete dentures)

80% 20% 80% 20%

Denture Repair 100% 0% 100% 0%

Simple Extractions 100% 0% 100% 0%

Orthodontics (for dependents to the end of the month in which they attain age 19) 50% 50% 50% 50%

Yearly Deductible None

Annual Maximum $1,000 per person based on calendar year

Orthodontic Lifetime MaximumProfessional staff: $2,000 per person

All other staff: $1,000 per person

Delta Dental PPO plus Premier Payment Example

Example Delta DentalPPO Premier Dentists

Non-ParticipatingDentists

Dentist’s Charge for a Crown (Example)

$1,000 $1,000

Sample Plan Payment Allowance $750 $900

Copayment Amount 80% 80%

Delta Dental Payment $600 $720

Patient Payment$150

($750 - $600 = )

$280($1,000 - $720 = )

Patient Savings

(over non-Delta Dental dentist)

$130($280 - $150 = )

$0

Note: These are hypothetical numbers for illustrative purposes only. Assume no maximum or deductibles are applicable.

Pretreatment Estimate

Determine costs ahead of time by asking your dentist to submit a predetermination before treatment is provided

Delta Dental provides an estimate of the cost of treatment and what we will pay

This free service helps you and your dentist make informed decisions about the cost of treatment

Work In Progress

Procedures performed after January 1 are paid by Delta Dental.

Procedures with dates of service prior to January 1 - other than orthodontic procedures – are paid by NCAS

For orthodontics, Delta Dental has received orthodontic history from NCAS and reviews date treatment began and the amount already paid toward the treatment

Delta Dental pays no more than the lifetime amount

Is YOUR Dentist a Delta Dental Dentist?

If not…

Delta Dental will recruit non-participating dentists on your behalf by targeting specific dentists in any location

Delta Dental encourages you to make referrals; recruitment cards can be made available

Customer Service

Toll-free “800” telephone number, including staffing by expert bilingual representatives; 97% of inquiries resolved on first call

Delta Dental’s Interactive Voice Response System (IVR) gives you and your dentist access to eligibility and benefit information after hours

Free predeterminations (pre-treatment estimates)

Notices of Payment

Customer Service: Hours

Looking for a Delta Dental participating dentist near you?Want to know your program benefits?

Call Delta Dental

(800) 932-0783 8:00 a.m. to 8:00 p.m.

(Eastern Time)

Monday through Friday

Online Services From Delta Dental’s Web Site

Easy-to-use participating dentist directories for all networks with maps and driving directions

Secure login for benefits and eligibility lookup• Access information on program benefits, eligibility,

status of deductibles, maximum usage, and claim status

Fee Finder for common procedures Printable claim forms Printable ID cards SmileKids – an interactive site for children Extensive dental health section E-mail inquiries to customer service Enrollee section in Spanish

www.deltadentalins.comwww.deltadentalins.com

Dentist Locator & Map with Directions

Eligibility & Benefits

Claim Status

Ability to check in-progress and processed claims.

Dental Fee Finder

Allows you to obtain estimates of the average cost of common dental procedures in your area by entering the first three digits of your ZIP code.

www.KeepKidsSmiling.com

Our site for children provides interactive games, coloring pages, teeth facts and other educational tools.

Delta Dental has largest dentist network in U.S. • Excellent access to Delta Dental dentists

Member Savings• Delta Dental’s PPO Premier network offers freedom of choice, dentist access and

savings opportunities for you

Member-friendly services• No balance billing on claims of Delta Dental dentists

• No claim forms with Delta Dental dentists

• Prompt claims processing

• Customer Service for Delta Dental PPO Premier available 8 a.m. to 8 p.m. (EST) Monday through Friday

• IVR services available after hours

Internet services• Easy-to-use participating dentist directories for all networks

• Secure login for benefits and eligibility lookup

What the Delta Dental Difference®

Means to YOU

We keep you smiling.®

www.deltadentalins.com