Be Better Informed Than the Tooth Fairy...
Our Annual Dental Survey

Welcome to Part I of California Broker’s 2010 Dental Survey. We’ve asked the top dental providers in California to answer 28 crucial questions to better help you, the agent, understand their benefits, features, and services. Look for Part II in the August issue. Read the responses and sell accordingly.

1. What types of plans do you offer?

Aetna: We offer the following dental plans:
• Aetna Dental Maintenance Organization (DMO(r)) plan
• PPO
• PPO Max
• Freedom-of-Choice Plan Design (offering members their choice of two dental plans)
• Aetna Dental Preventive CareSM
• Aetna DMO(R) Access
• Aetna Dental Care RewardSM
• Aetna DentalFund(r) (our consumer-directed dental plan)
• Indemnity
• Vital Savings by Aetna(r), a dental discount program.

All of our dental plans may be offered on a voluntary basis.
Ameritas: Ameritas has the following types of dental plans available nationwide: PPO, indemnity, voluntary, non-voluntary, groups from two lives and up, individual, consumer driven and cost containment plans.

Aflac: Voluntary Individual Table of Allowances plans.

Ameritas: Ameritas has the following types of dental plans available nationwide: PPO, indemnity, voluntary, non-voluntary, groups from two lives and up, individual, consumer driven and cost containment plans.

Anthem Blue Cross: Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company offer a comprehensive line-up of dental plans and products that include: PPOs and DHMOs for individuals, small groups, large groups and national accounts. We offer voluntary dental plans for small and large groups.

BEN-E-LECT: BEN-E-LECT offers fully-insured PPO, high deductible, pre-paid, and self-insured dental plans for the group market. Employer paid and voluntary down to two lives, with multiple network and out-of-network options down to the employee level.

BEST Health Plans: We offer the Advantage DHMO plans in Calif and Texas. A prepaid dental plan is available in Fla. as well. Advantage Plus PPO/Indemnity dental plans are available as a dual-choice option, alongside an Advantage DHMO plan.

Blue Shield: Blue Shield provides a wide range of affordable and comprehensive dental PPO and HMO plans. We offer dental PPO plans with MAC, UCR, and fee-for-service schedules. Our group dental PPO and HMO plans are offered on a contributory or voluntary basis. These plans can be sold as riders to health plans or on a stand-alone basis. Individual and family dental PPO and HMO plans are available to our IFP medical members as riders to health plans or we offer stand-alone dental PPO plans. We also offer two dental PPO plans developed specifically for Medicare Supplement plan members.

CIGNA: We offer the following dental plans:
• DPPO
• DEPO
• CIGNA Traditional - dental indemnity
• DHMO Standard plans and split co-pays for general dentists and specialists
• DHMO Value Plans – including flexible plan options with alternative treatment provisions.
• DHMO Preventive Plans
• CIGNAFlex Advantage (monthly switch feature between a DHMO and DPPO or dental indemnity plans)
• CIGNA Dental WellnessPlus
• CIGNAPlus Savings, a dental discount card program (not an insurance product).
• Dental Shared Administration – provides qualified funds and clients the administrative flexibility to pay their own dental claims and still take advantage of CIGNA Dental DPPO negotiated discounts and utilization management tools.

All plans are available on a stand-alone basis. All plans, except the discount card, are also available alongside medical and/or vision plans. CIGNA also has three WellnessPlus features, which can be paired with DPPO, DEPO, or dental indemnity products. Individuals who get any preventive care in one plan year qualify for increased benefits in the following plan year. All plans are available on a contributory or voluntary basis.

Dearborn National: Nationally, Dearborn National offers a flexible portfolio of dental plan options, as well as custom options for larger groups. With the proprietary claims adjudication system, employers have flexibility in customizing their dental plan. Funding options include fully insured, self insured, and voluntary plans. Dental plans are offered for groups as small as two employees to national accounts exceeding 40,000 employees.

In addition, with our partnership with Calif. Dental Networks (CDN), we offer both PPO plans and DHMO plan options in the state of Calif.
Delta Dental: Managed fee-for-service, PPO and DHMO group dental plans; individual DHMO dental plans and group HMO vision plans.

Dental Health Services: Prepaid dental benefit solutions for groups and individuals. We also offer PPO, EPO, and indemnity (reimbursement) products for groups of all sizes and ASO services for self-funded groups.

Golden West: Golden West Dental & Vision offers a comprehensive line-up of dental plans and products that include: PP0 (nationally), dual option, triple option, stand-alone and DHMO for individuals, small groups, and large groups. We offer voluntary dental plans for small and large groups.

Guardian: Dental PPO (active or passive), prepaid/DHMO, and indemnity plans are available on a voluntary or employer-sponsored basis. Dual and triple choice, monthly switch (between a DHMO and PPO), and administrative-services only plans are also available. Guardian’s flexibility allows us to customize plans based on the needs and price points of the employer group, whether small or large.

Health Net Dental: Health Net Dental HMO (DHMO) plans and dental PPO plans offer robust benefits covering most dental procedures. Dental plans may be purchased in conjunction with a Health Net medical plan or on a stand-alone basis. In addition, the dental plans may be purchased as dual choice.

HumanaDental: PPO, prepaid/DHMO, traditional preferred, and preventive plus plans available on a voluntary or employer-sponsored basis. Humana also has a robust ASO dental plan available in California.

MetLife: MetLife offers dental PPO, dental PPO-co-pay, dental HMO, and Indemnity plans with flexible designs and funding arrangements available to accommodate employer plan requirements. MetLife offers single or multi options, fully insured or self-funded as well as a full range of contribution options.

Group dental insurance policies featuring the Preferred Dentist Program are underwritten by Metropolitan Life Insurance Company, New York, NY 10166. Dental HMO plans are available in Calif., Fla. and Texas only, through a domestic company in the applicable state named SafeGuard Health Plans Inc. The SafeGuard companies are part of the MetLife family of companies. “Dental HMO” is used to refer to products that may differ by state of residence of enrollee, including but not limited to: “Specialized Health Care Service Plans” in Calif.

Principal Financial Group: We offer both employer paid and voluntary plans, including PPO, EPO, and POS. We also offer a choice between our plans and dental HMO plans through marketing alliances.

Securian Dental: Group dental PPO and indemnity.

United Concordia Dental: United Concordia Dental offers flexible fully insured PPO and DHMO plans as well as an individual product, iDental. ASO funding arrangements are available based on group size. Most plans can be offered on an employer-sponsored or voluntary basis.
Western Dental: Western Dental offers a DHMO mixed-model provider panel comprised of (a)contracted independent, general dentists and specialists, along with (b) Western Dental employee dentists and specialists, who work in the company’s owned Western Dental Centers. Western Dental currently operates over 220 general dentistry and orthodontic office throughout Calif., Ariz., and Nev.

2. How do plans you offer for the individual and\or small group compare in rates and benefits to the large-group plans?

Aetna: The key difference between Aetna small group plans and larger group plans is that small group plans are pre-packaged plan designs. While larger groups can select from an array of benefits, the packaged small group plans are comprehensive yet price sensitive and make it easy for our customers to choose from plans that are competitive in the market.

Aflac: Our rates and benefits do not vary based upon the size of the account.
However, when replacing existing dental coverage in larger accounts,
waiting periods may be significantly reduced.

Ameritas: Ameritas’ small group and one life group plans are rated by industry and are pooled in full or in part. Large groups’ experience is rated and includes lower rates in most cases. Ameritas offers a wide variety of plan designs, regardless of group size, to meet the needs of our customers.
Anthem Blue Cross: Anthem Blue Cross normally uses the same provider network for individual, small group, and large group. There are different underwriting considerations for each business segment depending on the product offered. Our larger groups can customize benefits to meet their employees’ needs.

BEN-E-LECT: The majority of our plans compete very well in the large group market. The benefit design and structure of our plans remain consistent across the small and large group markets.

BEST Health Plans: BEST Health Plans’ Advantage DHMO plans offer orthodontic benefits to groups with two or more enrolling. Prepaid S200 and S500 are available to groups with a minimum of 15 employees enrolled. Rates for Calif. and Texas DHMO plans vary by employer-contribution. Fla. prepaid Dental plans offer the same rates for employer-contributory and voluntary plans.

Blue Shield: Rates for our large group dental HMO and PPO plans are typically lower than our small group and IFP plans due to customization of offerings for groups with more than 300 employees. Rates may vary depending on the actual plan design. We offer one dental HMO and one dental PPO network regardless of participation in a group or individual/family plan. Group plans offered vary in deductibles and annual benefit maximums. Our individual, family, and medicare Supplement dental plans vary in waiting periods, deductibles, and annual benefit maximums. All comprehensive dental plans offered include generous benefits, competitive premiums, and our strong Calif. and national provider networks.

CIGNA: Dental plan designs and rates for small groups are similar to those of large groups. There are a series of standard DHMO plan designs and DPPO/indemnity plan designs. CIGNA does not currently offer dental plans to individuals. Larger groups generally want more robust and flexible plans while smaller groups gravitate toward standard offerings. We can custom-fit DPPO plans to offer a variety of cost-saving options for employers that want to keep claims costs low, such as missing tooth limitations, class shifting, low maximums, varying coinsurance, deductibles, waiting periods, etc. Our DHMO plans start with basic coverage, specialty discount, split co-pays, and other cost savings mechanisms. They go up to very rich, low-co-pay plans at the higher end of the cost spectrum. Through recent acquisitions, CIGNA can also deliver solutions for the smaller employer segment through the CIGNA voluntary limited benefit dental plan as well as leveraging the small segment capabilities of the former Great West distribution channel. We provide the full spectrum of products, each with varying price points based on product, funding type, and voluntary vs. contributory.

Dearborn National: Dearborn National offers dental plans nationally for groups as small as two employees to large-group plans. There is an extensive portfolio of standard plan design options for small groups. Large-group plans can customize their plan designs to fit their needs. Pricing is determined by demographics, group size, and the region the employees are in.

Delta Dental: While benefits offered to smaller groups are comparable to those offered to larger groups, larger groups have more options in terms of plan designs. Rates can be slightly higher for smaller clients and individuals, but Delta Dental strives to be competitive while balancing our financial risk. With individual DHMO plan benefits, we offer three different plan options — two for individuals and families and one customized for seniors. The individual and family plans offer a wide range of covered services. The senior plan is designed to offer services most utilized by this particular population.

Dental Health Services: All plans and premiums are developed based on individual and group needs. Co-payments and treatment options vary by plan, from very low levels of coverage all the way up to plans that provide member care at zero out-of-pocket cost. We have products starting at only $6.25, ranging to very high benefit plans. Customized plan designs are always available.

Golden West: Our small and large group products are specific to location, size, industry and contributions. While larger groups have more flexibility in customizing benefit options than do smaller groups, Golden West still focuses on plan flexibility for all size groups. This enables employers to custom design their products for their personal needs.

Guardian: Guardian offers nearly the same plan options to small group employers as to large employers. We offer an array of cost-reducing options, such as waiting periods, deferral of services, and tie-ins to Guardian vision or Guardian medical products. Dental coverage is not available to individuals.

Health Net Dental: DHMO plans offered to individuals provide a comprehensive schedule of benefits at a monthly fee that is slightly higher than rates quoted for groups. Small groups (2–50 employees) have two comprehensive Health Net Plus DHMO and 13 DPPO plans from which to choose. Mid-market groups (51–250 employees) may choose from five DHMO plans and 15 new DPPO plans. Mid-market rates are based on location, benefit plan chosen, employer contributions and participation. Individual and small group rates are based on book rates. Risk evaluation is taken into consideration when underwriting larger groups (over 250 eligible employees).

HumanaDental: We offer flexible plan designs with a range of deductibles, co-payments, and out-of-pocket expense limits to meet the needs of small to large groups. We also offer large groups the additional flexibility to customize plan options. Customers who see dentists participating in the HumanaDental PPO Network receive deep discounts. In Calif., our negotiated discounts average 34% off billed charges. All our dental plans provide employees with incentives for preventive dental care, which promotes their overall health. A free vision discount program is included.

MetLife: MetLife offers individual plans in Calif., Fla., and Texas though SafeGuard, a MetLife company. Dental HMO plans offered to individuals provide a mid-range level of benefits at a monthly fee that is slightly higher than rates quoted for groups.

Small groups (2-50 eligible lives) have a broad range of options within the Dental PPO and Dental HMO benefit plans. Rates are based on location, plan chosen, and participation. Risk evaluation is taken into consideration when underwriting larger groups; individual plans are quoted using shelf rates.

Principal Financial Group: The only significant rating difference pertains to experience rating, which is used on groups with 150+ employees. There are also, however, a few benefit limitations on very small cases, which apply to groups under 10 lives.

Securian Dental: Small group rates are developed on a pooled basis. Large group rates are developed on a custom basis.

United Concordia Dental: The primary factors that affect our group rates are location, experience, and credibility. While larger groups have more flexibility in customizing benefit options than smaller groups, United Concordia Dental offers an array of standard group products and options that provide small businesses with cost-effective, quality choices.

Western Dental: Our individual and small group rates are a little higher for standard benefit plans. Customized benefits plans are available for large groups.

3. Is your plan(s) better than previous incarnations? If so, how?

Aetna: Evidence-Based Policies: We determine which services should be covered based on the following:
• Major dental studies.
• New clinical advances.
• Recommendations from the leading health and dental organizations.
• Consultations with academic leaders on the latest technology and techniques now taught in dental schools.

We do not cover services that research shows as experimental, investigational or unproven. We do not cover ViziLite, VELscope, or brush biopsies. There is no evidence showing that using these services are an improvement over conventional oral cancer screening. The Journal of the American Dental Association (JADA) recently published results from a study that indicated that use of ViziLite or VELscope along with a conventional screening examination for lesions deemed clinically innocuous was not beneficial in identifying dysplasia or cancer.
We offer the following:

Freedom-of-Choice Plan Design -- Packages our DMO plan with one of our Indemnity or PPO plan options. Members pay one rate and can switch between the plans as often as monthly. It can be a lower cost alternative to a PPO plan.

Aetna Dental Preventive Care -- A low-cost PPO or Indemnity plan covers preventive and diagnostic procedures from 70% to 100%. Members may also get reduced fees from dentists who participate in Aetna’s PPO network for non-covered services like fillings, adult orthodontia, and cosmetic tooth whitening.

Aetna DMO Access -- A fixed-co-pay DMO plan offers broader network access at a lower cost. There are no out-of-pocket deductibles for the member to pay and no claim forms to file. It also includes the Aetna Dental Access discount network, which gives members access to more dentists and discounts of 15% to 50% for non-covered services like bleaching.

Aetna Dental Care Reward -- By going to the dentist for preventive services in one plan year, Aetna will cover a greater percentage of coinsurance and/or annual maximum next plan year.
Ameritas: Ameritas is known for our flexibility and expertise in dental. We talk to employers all over the country for input on their needs. Our plans are updated constantly to meet those needs. We have released several industry firsts including a rollover maximum product, fully insured Lasik eye benefits, dollar reimbursement plans, combined dental/vision deductible, frequency and maximum plans, shared family maximum plans, and stand-alone hearing care benefits.

Aflac: We have not had any plan changes since the latest plan was
introduced in 2004.

Ameritas: Ameritas is known for our flexibility and expertise in dental. We talk to employers all over the country for input on their needs. Our plans are updated constantly to meet those needs. We have released several industry firsts including a rollover maximum product, fully insured Lasik eye benefits, dollar reimbursement plans, combined dental/vision deductible, frequency and maximum plans, shared family maximum plans, and stand-alone hearing care benefits.

Anthem Blue Cross: With the Dental Blue PPO plans from Anthem

Blue Cross Life and Health Insurance Company; there is greater access to more dentists in more locations. This increases the likelihood that members will have access to their own current dentist, increasing their satisfaction with their dental plan. The three networks offer flexibility in plan options and Dental Blue specialists participate in all three networks. Additionally, members have access to our negotiated discounts on non-covered services (such as veneers, implants, temporal mandibular joint dysfunction (TMD), and orthodontia), negotiated discounts after the annual maximum has been reached and negotiated discounts during waiting periods (if applicable). We have eliminated waiting periods for small group dental plans. The Anthem Blue Cross large group DHMO plans - the Dental Net 2000 Series Plans - are more cost-effective and consumer-friendly, with increased flexibility and choice. The plans include enhanced benefits for services not previously offered and often not offered by other plans. Our Tonik and Enhanced Tonik individual plans, designed for younger members, offer choice and affordability with a dental plan that’s embedded within a medical product.

We have also introduced a new International Emergency Dental Program for all of our dental members, and we offer extra cleanings and periodontal maintenance procedures for our Dental Blue members, which does not count toward the annual maximum.

In addition, we just launched new large group Dental Blue plans in California, which offer more flexibility and various out-of-network options, along with five additional new riders.

BEN-E-LECT: Our plans offer more options for employers and employees than do any other dental plan in the market. They can be written stand-alone or the employer may combine our plans for a complete package offering PPO, DHMO and fully self funded options.

Blue Shield: The new oral cancer screening coverage is not only a value-added benefit, but also comes at no out-of-pocket cost to the member. And the standalone IFP dental plans give brokers a much wider pool of potential prospects since these plans can be sold to those without Blue Shield
medical coverage.

CIGNA: Our DHMO 07 Series features four cleanings per year, two at $0 co-pay and another two at a minimal co-pay, when recommended by the network dentist; expanded fluoride treatment options; and a robust variety of schedules and co-pay structures. The 07 Series is focused on affordability, preventive care, and wellness. Teeth whitening (take-home trays with bleaching gel) is also available on most of the 07 schedules. We’ve added free identity theft resolution services with this Series.

CIGNA added the D Series for clients that can’t afford to continue offering full service plans or those that thought they couldn’t afford dental coverage. It offers preventive and diagnostic coverage only. It provides preventive dental services and access to network discounts for services that aren’t covered under the plan.

CIGNA’s dental plans include several enhancements, such as coverage for oral cancer screening procedures including brush biopsy and VizilitePlus. We removed the age limit on sealants for DHMO plans. On most schedules, individuals don’t need a referral to a pediatric dentist for dependent children under seven. Individuals can also visit network orthodontists without a referral. Our WellnessPlus features reward individuals for getting preventive care by increasing their benefits in the following plan year. Dental customers also get discounts on xylitol products, health management programs, and other valuable health and wellness products and services.

The DPPO network now gives employers more choice. The CIGNA Dental Core Network is appropriate for employers looking for a strong balance between network access and discounts. The larger CIGNA Dental Radius Network offers the greatest nationwide access to dentists at all discount levels and is appropriate for employers where network size is the primary driver.

Those enrolled in the CIGNA Dental PPO (DPPO) or Dental EPO (DEPO) plan get discounts on non-covered services (where allowed by law). The discounts also apply to covered services when they exceed their annual maximum or other plan limitations, such as frequency, age or missing tooth. Employees get lower out-of-pocket expenses since most of our DPPO network dentists have agreed to offer enrollees their negotiated contracted fees for most non-covered services.

Targeting availability for Jan. 1, 2011, the Dental Network Savings Program (DNSP) will become a standard cost-containment feature for DPPO (except MAC and scheduled benefit plans) and indemnity clients. The DNSP provides access to a supplemental network of dentists who provide out-of-network care at a discounted rate. This means additional claim savings for clients and lower out-of-pocket costs for customers when they use a participating DNSP dentist. The DNSP allows us to provide an additional tier of discounted access points and incremental savings for clients and customers. Finally, we have added both identity theft and will preparation enhancements to the CIGNAPlus Savings discount card (not an insurance product).

Dearborn National: When Dearborn National first entered the PPO dental marketplace, we filled the niche on voluntary dental plan needs. We have since expanded to offer fully insured employer paid and self-funded dental benefits. In addition, due to the flexible proprietary claims system, the custom benefit plan design options are extremely robust. In addition to offering excellent discounts, and customer service, Dearborn National also offers the largest PPO network of dental access points, with now over 150,000.

New DHMO products were created to cover additional cleanings (beyond the standard two times per year), alternative name brand crowns, and many other services typically used to up-sell patients.

Delta Dental: Most mid-large group plans can be customized within basic parameters. We incorporate changes in treatment standards and technology as they evolve. Delta Dental has added the following enhancements to our standard benefit package:
• Coverage allowed for one panoramic x-ray and one full mouth x-ray within the five-year frequency limitation for each of these procedures.
• Coverage for IV sedation to mirror general anesthesia for covered oral surgery
• Coverage allowed for IV sedation and general anesthesia for select endodontic and periodontal procedures.
Previous enhancements include the following:
• Coverage for dental implants, implant-supported prosthetics and other implant services.
• A benefit enhancement during pregnancy, which includes an additional oral evaluation and either one additional prophylaxis (D1110); up to four quadrants of periodontal scaling/root planing (D4341/D4342); or one additional periodontal maintenance procedure (D4910) (Written confirmation of the pregnancy must be provided by the enrollee or the dentist when the claim is submitted.)
• The option of waiving the annual maximum on diagnostic and preventive services (cost impact varies based on client’s existing plan design).

Dental Health Services: We offer a number of cosmetic procedures as standard benefits in our plans. In addition, monthly premium rates and co-payments for services are evaluated frequently to ensure that they are appropriate and competitive.

Golden West: Most recently, we launched our High/Low PPO and Triple Option dental plans, which allow employees to choose their own level of coverage. In addition, our low cost DHMO plans offer cosmetic and elective procedures as an option in addition to our free vision and ortho benefits for all DHMO and PPO (CA) members.

Guardian: We can vary deductibles, annual, and lifetime maximums and service frequencies; include deferrals of services; move services or groups of service to different service categories; and offer many coverage options including implants and cosmetic services. We also offer MAC plans, incentive coinsurance, incentive maximum, preventive-only, and preventive-plus plans. Plans can be tailored exactly to meet almost any client’s requirements while providing the prompt case implementation and rapid claim processing that our systems have always ensured.

Health Net Dental: Health Net is pleased to introduce new DPPO plans for small and mid-market groups. All of our new DPPO plans include extra services for pregnant women in their second and third trimesters, including extra cleanings, scaling, and debridement covered at 100% in and out of network and not subject to the plan’s deductible. Our new Classic Plus DPPO Plans include MaxAdvantage, our rewards program that allows members to carry over a portion of their calendar year maximum into the next calendar year. Our new Basic DPPO is a unique plan offering in- and out-of-network coverage for preventive, diagnostic, and restorative procedures (oral surgery, endodontics, periodontics, major services and orthodontia not covered).

For new groups purchasing a dental PPO plan with coverage for orthodontia, the orthodontic lifetime maximum starts over, even for members who have previously started treatment. We do not require the prior carrier’s PPO orthodontic paid claims and there is no reduction of the member’s lifetime orthodontia maximum for treatment already in progress.

The Health Net Dental Plus DHMO plans offer more than 340 covered benefits, including oral cancer screenings, additional teeth cleanings, teeth whitening and veneers. In addition, members have access to one of the largest DHMO networks in the state.

HumanaDental: Yes, we continually explore ways to offer more choices and flexibility for our customers. Please see next response.

MetLife: We are continually improving our program contracts, plan design flexibility, claims-processing guidelines, customer service, and quality programs based upon clinical research, consumer-value approaches, and dental industry trends.

MetLife continues to expand our product offerings and plan design flexibility in the small (under 500 employee) market – providing more choices to help them meet cost objectives without sacrificing quality.

Principal Financial Group: Our current plan offers significant flexibility in plan design, optional coverage for cosmetic services, TMJ treatment, dental implant coverage, accident coverage, employee choice options, and multiple price points. Employers can design any combination of plan options to meet their needs.

Securian Dental: We have added greater flexibility.

United Concordia Dental: In recent years we have done the following:
• Introduced more voluntary plan options and added optional coverage for posterior composite restorations and implants to groups with 10 or more enrollees.
• With our DHMO plan in Calif., we added more than 70 procedures, now covering over 300 in total.
• We launched Preventive Incentive, which covers diagnostic and preventive services without counting them toward the member’s annual maximum.
• Enhanced our employee oral health educational offerings.
• Introduced the Smile for Health program in 2007, which includes a maternity dental benefit that provides an additional cleaning during pregnancy. An enhanced dental benefit provides coverage for certain diagnostic, preventive and periodontal services that help dentists to identify and treat chronic oral infections.
• Launched a series of plan designs through iDental, our dental product for individuals and families without coverage elsewhere.

Western Dental: Western Dental Benefits Division recently launched the DHMO Series 7 dental plans. Our new plans offer an increase of covered procedures to include the availability of cosmetic alternatives and more orthodontic options for children and adults.

4. What have been the most recent changes in your plan(s)?

Aetna: Full mouth debridement will be covered as a major service and will be a standard on all new DMO, dental PPO and indemnity plans with effective dates of October 1, 2010 and later. This procedure is part of our Dental/Medical Integration program enhanced benefits.

Aflac:N/A

Ameritas: A shared family maximum plan is being rolled out.

BEST Health Plans: We launched our DHMO/prepaid dental product lines in January. The California DHMO plans offer no office visit fees as well as posterior composites and oral cancer screenings at fixed co-payments. There is no charge for most diagnostic and preventive services. Enrolled members can access their information through a member portal to access our dentist locator, a treatment cost calculator, to verify eligibility, request ID cards, and review plan information. A dental education section helps our members stay informed on recommended dental health practices.

Anthem Blue Cross: We recently introduced a new International

Emergency Dental Program for all of our dental members, and we offer extra cleanings and periodontal maintenance procedures for our Dental Blue members, which does not count toward the annual maximum.

In addition, we just launched new large group Dental Blue plans in California, which offer more flexibility and various out-of-network options, along with five additional new riders.

Blue Shield: We recently reduced pricing on four of our small group dental plans. We rolled out our Suite Deal Dental package that increases the number of plans small group employers can offer from two to five.

BEN-E-LECT: Our Freedom PPO Plans have added the option to waive the waiting period for groups with no prior coverage. The addition of our new Freedom pre-paid Dental Plans (made available by Western Dental exclusively for BEN-E-LECT) has been a well-received addition.

Blue Shield: In response to market demand, Blue Shield developed two stand-alone dental plans for the IFP market – one comprehensive Smile PPO dental plan and one affordable Value Smile PPO dental plan. Now brokers can sell Blue Shield dental coverage to individuals and families with or without Blue Shield medical coverage. Beginning June 1, we added a third teeth cleaning per year covered at 100% when using a network provider for Dental PPO plans designed specifically for our Medicare supplement plan members.

In addition, all Blue Shield dental PPO plans now cover oral cancer screenings as a preventive and diagnostic benefit, covered at 100% for the member. Additionally, we’ve expanded our dental PPO network of providers from 77,000 to nearly 110,000 nationwide.

CIGNA: CIGNA’s dental plans address emerging research on the connection between oral health and overall health. CIGNA pioneered the introduction of integrated benefits between medical and dental in 2006 with our Oral Health Integration Program, which offers enhanced dental coverage to address populations at risk, such as those with diabetes, heart disease, or those who are pregnant. In addition, CIGNA’s dental plans cover oral cancer screening procedures such as brush biopsy and VizilitePlus to aid in the early detection of oral cancer. We also don’t have an age limit on sealants for DHMO plans. CIGNA offers a complete package of very competitive dental plan designs with some of the largest national dental networks. CIGNA enhanced our dental treatment cost estimator and launched our periodontal risk assessment and cavity risk assessment tools. Both assessment tools are available in English and Spanish. CIGNA also developed an oral cancer awareness quiz and an online toolkit to help parents care for their children’s teeth.

Dearborn National: Dearborn National recently announced enhancements to their dental PPO plan, such as availability to cover implants, and the option for groups to have annual open enrollment without waiting periods.

Delta Dental: We’ve recently enhanced the Benefits Administrator Support Guide on our website. It features new content, including an administrative manual and our extensive dental health flyer library. As part of Delta Dental’s initiatives to reduce environmental impact, we provide many resources in the enhanced guide to help benefits administrators “go electronic” in their communications with employees.

Dental Health Services: Our plans provide coverage for composites on posterior teeth, re-treatment on root canals, fixed fees for precious metals and porcelain on molars, titanium crowns, teeth whitening, and other cosmetic procedures.

Golden West: Our DHMO network has increased to over 4,800 participating providers; our national PPO plan reaches over 79,000 participating providers. Our PPO plans offer industry discounts, which qualifies employers up to as much as 15% discount off PPO pricing. For DHMO plans, self-referrals have been routine for our plan participants. Our Individual SmileChoice plan includes cosmetic/elective benefits, vision and ortho coverage.

Guardian: Guardian Choice is a new plan design, which allows employee choice between a MAC or UCR PPO plan using one blended rate and the ability to switch at annual open enrollment. We have introduced new features that encourage preventive care, allowing members to get even more value from their annual maximums including Maximum Rollover, Maximum Rollover Lite, and Preventive Advantage. Other PPO plan design enhancements include benefits for up to four periodontal treatments per year (with the option to cover under preventive), oral cancer screenings, adult fluoride, cosmetic teeth whitening, and the ability for employers to offer their employees a triple-choice plan. Our new enhanced DHMO plans will waive office visit co-pays after three years and include orthodontia in progress benefit and coverage for services such as oral cancer screenings and adult fluoride. We also introduced the Direct Referral program that allows DHMO members to see any in-network specialist without pre-authorization, providing faster, easier access to important treatment.

Health Net Dental: All of our Classic Plus, Classic, Essential and Basic DPPO plans include extra benefits for pregnant members in their second and third trimesters.

HumanaDental: Plans in our new generation of products are available as voluntary plans, and to groups with as few as two employees. Our new plans offer an extended maximum benefit, in which members get 30% coinsurance on services rendered after they reach their annual maximum. In addition, no waiting periods for major services for voluntary groups with 10 or more enrolled, open enrollment options, and orthodontia benefits. Updates include reimbursement options for out-of- network reimbursement: maximum allowable fee, or based on in-network fee schedules. Additional deductible choices, implant coverage, and acrylic filling coverage have also been added. Due to the connection between oral health and overall health, we have added, free of charge, oral cancer screenings to all of our products, excluding DHMO/prepaid plans.

MetLife: MetLife is offering the following:
• MetLife Dental Health Manager — This proprietary dental disease management program provides educational content and personalized report cards that illustrate participants’ risk for oral disease and general dental health. It is available to new and existing MetLife customers with 500 or more employees, at no additional cost as a standalone program. Employers also have the option to coordinate the program with a disease management vendor, which requires a one-time set-up fee.
• Back to the BASICs plan — This dual-option plan focuses on the essential dental services aligned with research, treatment protocols, and market trends to maximize the value to employers and their employees. The base plan has low monthly premiums and provides coverage for services needed to maintain oral health, such as preventive exams, cleanings, X-rays, fluoride, sealants, fillings, and more. Employees can choose the enhanced plan for more comprehensive coverage including coverage for orthodontia services. The enhanced plan also provides lower out-of-pocket costs through lower deductibles and higher coinsurance reimbursement and annual maximums.
• MetLife International Dental Travel Assistance Program — With this new program, participants who travel internationally get around-the-clock access to multilingual coordinators who can connect them with dental providers in over 200 countries.
• Provider Discounted Membership in the Institute of Medical Emergency Preparedness (IMEP).
• Enhanced Oral Health Library — MetLife launched an enhanced web-based consumer education resource, the MetLife Oral Health Library at www.metlife.com/dental and clicking on “MetLife Oral Health Library.”
• Enhanced Full Service Dental for Retirees — Expected to be available Summer 2010, this product enhancement will provide a Trust option for our Full Service Dental for Retirees product. This turnkey product allows customers to enrich their retiree benefits programs with no benefit expense and minimal administration. The new Trust features means no contracts to sign for employers while providing voluntary dental options for their retirees.

Principal Financial Group: Our newest feature to our dental plans is the Preventive Passport option. This feature excludes preventive services/charges from counting towards the annual maximum.

Securian Dental: More flexible participation guidelines. Escalating annual maximum and lifetime deductible options.

United Concordia Dental: United Concordia Dental introduced an individual product line, iDental, designed to meet the varying needs of a college student, an unemployed individual, a young family,
a senior citizen, or anyone else that may need quality dental care at an affordable price.

Western Dental: Our Series 7 plans cover more procedures and now include Implants, veneers and external bleaching.

5. Can an insured use their own dentist even if they are not on your participation list?

Aetna: PPO – We offer a national network of dentists. Each covered family member can visit any licensed dentist for covered services. When members visit dentists who participate in our network, their out-of-pocket costs are generally lower.
Indemnity – Members can visit any licensed dentist.
DMO – Members must seek care from a participating DMO provider unless a state allows a member to seek out of network care.

Aflac:Policyholders may use any dentist they choose as we do not have
network requirements.

Ameritas: Insureds can use any provider, but they may incur additional out-of-pocket expenses.

Anthem Blue Cross: Yes, they can with all of our PPO plans. Members who choose a provider, within the Dental Blue network, get the most savings in their dental costs. However, members can choose a non-Dental Blue dentist, but their out-of-pocket costs may be higher. The same is true for our traditional Prudent Buyer PPO dental plans. The DHMO plans are in-network only.

BEN-E-LECT: Yes, our plans offer both in and out of network coverage with multiple options for coverage and benefits. The member maintains complete control over the dentist they choose to utilize.

BEST Health Plans: Members on the Advantage DHMO/prepaid Dental plans must use a dentist in the network. If a member’s dentist is not part of the network, the member can nominate the dentist to join the Advantage network.

Blue Shield: Dental PPO plan members can choose to go to any dentist, although their benefits will be covered at a higher percentage when choosing a network dentist, with less out-of-pocket expense.

CIGNA: Insureds can use their own dentist in the DPPO and dental indemnity plans. However, there are no out-of-network benefits with DHMO, CIGNAPlus Savings dental discount plans (not insurance) or with DEPO. Individuals can nominate their dentist to join our plan and if the dentist wants to participate and meets our criteria, he/she will be credentialed and added to the network.
Additionally, DPPO and DEPO plans may include savings on most non-covered services. Most of our DPPO network dentists offer their negotiated contracted fees to customers and their covered dependents for most non-covered services. And the savings also apply to covered services when an individual exceeds his or her annual maximum or other plan limitations, such as frequency, age or missing tooth.

Dearborn National: In the PPO dental plan, members can use an in-network or out-of-network dentist. However, they save more by going to network dentists. In the DHMO plan, members must select a dentist that is in the network.

Delta Dental: Delta Dental Premier enrollees can visit any licensed dentist for care, although there are advantages to visiting one of more than 33,600 Delta Dental Premier dentists in Calif. Enrollees can go to any dentist, but they are only guaranteed to get in-network benefits and avoid balance billing when visiting a Delta Dental dentist. Delta Dental PPO enrollees also have freedom of choice, but can benefit from the protections associated with selecting one of more than 20,700 Delta Dental PPO dentists in Calif. PPO enrollees have access to both Delta Dental PPO and Premier dentist networks with different levels of savings.

DHMO enrollees must use a participating general dentist or approved specialist, except for
emergency care.

Dental Health Services: Our PPO and reimbursement plans allow members to get treatment from any dentist. Members of Dental Health Services’ prepaid and EPO plans choose their dentist from our
extensive network of participating dentists.

Golden West: Members who are covered under our True Advantage

PPO and indemnity plans can get services from a non-panel provider. Their greatest discounts will be through our panel providers under our True Advantage PPO plan.

Guardian: Members who are covered under our PPO plans can visit any dentist. However, benefits may be paid at a lower coinsurance rate for non-participating dentists. DHMO members must choose a participating primary care dentist.

Health Net Dental: Our dental PPO plans offer members freedom of choice; members may receive services from any licensed dentist, but we will reduce their out-of-pocket costs by receiving services from a participating PPO dentist. Under Health Net Dental DHMO plan, members must use a participating dentist to receive benefits.

HumanaDental: PPO members can visit the dentists of their choice. Out-of-pocket savings are great when members visit participating network dentists.

MetLife: For Dental PPO plans, plan participants can visit any dentist and receive benefits. Participants may realize additional expense savings by receiving services from a participating dentist. For Dental HMO, members must use a participating dentist to utilize their benefits.

Principal Financial Group: Our members can see any dentist (even if the dentist is not on the participation list) if they are enrolled in either our PPO or POS design. If a member is enrolled in our EPO design, they must see network dentists for services in order to receive coverage.

Securian Dental: Yes.

United Concordia Dental: Our FFS and PPO plans allow members to visit any dentist. However, out-of-pocket costs may be higher when visiting a non-participating dentist. DHMO members must use network dentists.

Western Dental: Through the DMO plans, the member must use a dentist who participates in our network in order to have coverage.

6. If the dentist bill exceeds UCR, can the dentist bill the patient for the difference?

Aetna: For covered services, network dentists are contractually prevented from balance billing above the negotiated rate. Non-covered services are also available for a discount in most states. Dentists who are not in our networks may balance bill members.

Aflac:We pay benefits based on a Table of Allowances and not UCR. If the
dentist’s charge exceeds the benefit amount paid, the dentist may
balance-bill the patient.

Ameritas PPO and the First Dental Health (FDH) Networks: Ameritas PPO dentists and FDH PPO dentists are bound by contract not to balance bill the difference between their normal charge and PPO maximum allowable charges. Most Ameritas PPO providers offer a discount on non-covered procedures (if allowed by the state) and members are financially
responsible for those charges.

Anthem Blue Cross: No, not when visiting an Anthem Blue Cross dental PPO provider. Anthem Blue Cross participating provider contracts include negotiated fee agreements that prohibit balance billing. A participating dentist may not balance-bill members for amounts that exceed the negotiated and contractually agreed on fee. Members are not responsible for amounts in excess of negotiated rates. However, if a member visits an out-of-network provider, there is no contract and the provider can bill the patient for the difference. With our DHMO plans, the patient is only responsible for co-payments and non-covered services when accessing services through their participating dental provider

BEN-E-LECT: The member does have the option to choose this method upon enrollment.

BEST Health Plans: No, network dentists are contracted not to balance bill our members.

Blue Shield: In-network providers cannot bill members for fees that exceed the negotiated rate. Out-of-network providers, however, may bill for charges that exceed the plan’s allowed amount.

CIGNA: In-network dentists are not allowed to balance bill for covered services. We can’t prevent non-network dentists from balance billing.

Dearborn National: If a member sees an in-network dentist, per our contract, dentists are not allowed to balance bill. However, if a member sees an out-of-network dentist, that provider could balance bill the member.

Delta Dental: Contracted dentists agree not to balance bill patients for services covered under the program for which he or she has contracted service fees. Delta Dental holds its Delta Dental PPO and Premier dentists to their contracted fees when providing services to eligible enrollees.

DHMO enrollees do not pay more than their set co-payment for benefits under the DeltaCare USA plan. Specialists are paid the difference for charges exceeding the enrollee’s co-payment for all preauthorized services. When an enrollee chooses a more costly procedure not covered under the plan, the enrollee is responsible for the difference in cost between the network dentist’s usual fees for the covered procedure and the optional treatment, plus applicable co-payment for the covered procedure.

Dental Health Services: No, members utilizing in-network benefits on our prepaid and PPO plans are protected from paying unexpected, additional fees from their dentist.

Golden West: Network dentists are contractually prevented from balance billing above the negotiated rate. Non-panel dentists can balance bill a PPO or indemnity member the difference of the billed fee and the average fee charged for that particular geographic area.

Guardian: Guardian’s PPO dentists are prohibited from billing members for any difference between the billed fee and the contracted fee schedule amount, less applicable deductibles and coinsurance.

Health Net Dental: When receiving services from a participating PPO dentist, members cannot be billed any charge in excess of the maximum allowable charge established by the plan. If the member goes to a non-participating dentist, the dentist can bill the patient for the difference between the allowed amount for the plan benefit and the dentist’s submitted charge.

HumanaDental: PPO members can visit the dentists of their choice. Out-of-pocket savings are great when members visit participating network dentists.

MetLife: When receiving services from a participating Dental PPO dentist, eligible employees and dependents cannot be billed any charge in excess of our maximum allowable fee (minus any plan benefits). If the patient goes to a non-network dentist, the dentist can bill the patient for the difference between the plan benefit and the dentist’s submitted charge. When receiving services from a participating Dental HMO dentist, members cannot be billed any charge in excess of the specified plan co-payments, listed in the Schedule of Benefits for their plan. For some SafeGuard Dental HMO plans, there is a 25% fee reduction off of a participating dentist’s customary fee for non-listed procedures. (Members are responsible for the participating dentist’s full fee for procedures specifically excluded from coverage).

Principal Financial Group: Dentists cannot bill over the UCR amount if they are part of our PPO or EPO networks. A dentist that is not a part of one of our networks can bill the amount over UCR.

Securian Dental: If the dentist is part of our network – no. If the dentist is not part of our network – yes.

United Concordia Dental: Contractually, United Concordia Dental participating dentists agree to accept our allowances as payment in full for covered services (less any deductibles and coinsurances or co-payments).

Western Dental: Since this is a managed care plan, members pay only the applicable co-payment listed on their benefit schedule. Members are financially responsible for non-covered procedures at a discount.

7. How does the dental plan protect against over billing or waiver of co-payments?

Aetna: Our explanation of benefits (EOBs) shows the member’s out of-pocket responsibility. A copy is sent to both member and provider. If necessary, the provider relations area helps to resolve any issues whether related to over billing, waiver of co-payments, or other issues.

Ameritas: The explanation of benefits calculates the insured’s portion of the bill automatically to prevent these kinds of problems.

Anthem Blue Cross: Anthem Blue Cross’ extensive contracts with participating Dental Blue providers address these issues to avoid over billing and co-payment waivers. The same is true for our traditional. Prudent Buyer PPO dental plans. Additionally, our quality assurance teams assess claims and providers regularly to ensure our DHMO members are getting the highest level of service and satisfaction. For the PPO product, the service and satisfaction monitoring would be through the grievance and appeal process.

BEST Health Plans: Network dentists are contracted to accept capitation and member co-payments as full payment. Members receive information on how their plan works at the time of enrollment. Our member portal also provides a treatment cost calculator, and helps members understand how they will be billed for treatment they receive. Member complaints are forwarded to our Provider Relations Department for review and resolution.

Blue Shield: Our contract with in-network providers stipulates that they cannot bill members for fees that exceed the negotiated rate. Any complaints from members about balance billing by providers are forwarded to our Provider Relations Department for review and resolution.

CIGNA: Balance billing for covered procedures is strictly prohibited. We counsel network dentists who do not comply. Continued balance billing may be referred to our Credentialing Committee for review of future participation in the network. CIGNA monitors allegations of overcharging through enrollee feedback, surveys, and the dental network management staff.

For DHMO plans, the collection of co-pays is between the patient and the dentist. We encourage dentists to collect co-pays at the time treatment is rendered. For DPPO/Indemnity plans, it is illegal in some states for dentists to routinely waive deductibles. Since our group contracts indicate that CIGNA is not responsible for any charge the patient is not required to pay, we may reduce our claim payment by the co-pay amount waived by the dentist. Our Investigations Unit may also contact the dentist and the patient for further information and has the ability to review claims on an ongoing basis.

Delta Dental: Delta Dental Premier and PPO dentists contract with us to establish acceptable fees as well as formally agree to certain protections for Delta Dental enrollees. Protections include: no balance billing — contracted dentists cannot charge enrollees for the difference between their contracted Delta Dental fee and their submitted charge for a service; they may only collect the patient portion (co-payment plus any deductible and/or amount over the annual maximum) at the time of service. Delta Dental dentists also agree not to unbundle a procedure that is on file with Delta Dental as one procedure.

Waiver of plan co-payments and deductibles is considered fraudulent and is handled by notifying the dentist of the violation and possible network termination.

DHMO network dentists agree to be paid by Delta Dental on a guaranteed capitation basis. They also contractually agree to accept enrollee co-payments as payment in full for covered dental procedures and not to seek additional fees. If a dentist consistently demonstrates a disregard for their contractual obligations with Delta Dental their participation may be restricted or terminated.

Dental Health Services: Participating dentists’ charts are audited on-site on an ongoing basis to ensure treatment is rendered in accordance with Dental Health Services’ policies. In addition, plan members get extensive patient education and tools to help them understand their plan benefits so they can question charges that may not be in compliance with plan benefits. Members are encouraged to contact the plan for assistance if they feel they are being overcharged.

Golden West: Explanation-of-benefits statements are sent to members identifying the discounts taken and the member’s responsibility. The compliance department and dental consultant monitor utilization. Additionally, a proprietary claims system identifies over-utilization trends and patterns.

Guardian: Guardian’s PPO dentists may only charge members for any covered charges other than the deductible or coinsurance that may apply to the discounted fee schedule amount. Explanation of benefits statements sent to members identify the discounts taken and the member’s responsibility.

Health Net Dental: Under our DPPO and DHMO plans, participating dentists are contractually prohibited from balance billing a member more than the maximum allowable charge or the contracted copayment amount. Practices are in place to discipline network dentists who attempt to bill members more than these contracted amounts.

If it is determined that a participating dentist has overcharged a member, our Customer Service team will contact the provider on behalf of the member to confirm benefits and re-educate the office about proper plan collection from a member. If the provider refuses to comply with the plan design, the issue is escalated to the Professional Relations Department for follow-up with the provider. Depending on the circumstances, the issue could be escalated to our Quality Management Team, which follows state mandates for a full investigation, including the request for patient records from the office and a review by a dental professional. These investigations must be completed within 30 days and written communications are sent to both the member and provider. If the provider still refuses to comply, our Legal Department would be contacted and steps may be taken to terminate our relationship with the provider. In these rare instances, it might become necessary for the plan to reimburse the member or provider depending on the circumstances and to ensure a positive member experience.

HumanaDental: The dentist and the patient get an explanation of benefits to ensure that the dentist does not overcharge or omit fees. The claims processing systems adjudicates the claim based on the contracted fee schedule. Waiving co-payments does not apply under a PPO.

MetLife: For Dental PPO, our explanation-of-benefits is our first protection for the patient against over-billing. It clearly identifies the charges for services that the patient has a responsibility to pay. In addition, our customer service area gathers information from the patient and investigates the issue fully. A response with our findings is provided to the patient. Waiver of co-payments can also be identified from calls to our customer service center and our auditing unit, which looks for atypical billing patterns.

For the Dental HMO, the dentist’s agreement prohibits billing a member above the specified co-payment. The plan conducts a thorough orientation with each dental office. The Quality Management department reviews member complaints that relate to charges. The Office Quality Assessment reviewer notes any apparent overcharges during the patient-record audit and works with the dentist’s office to correct the issues.

Principal Financial Group: Provider utilization patterns are studied and issues are addressed as they are uncovered.

Securian Dental: We systematically check every submitted claim.

United Concordia Dental: United Concordia Dental participating dentists contractually agree to only bill members for applicable deductibles, coinsurance, or amounts exceeding the plan maximums. In addition, members get explanations of benefits that clearly describe the services received and their financial responsibility.

Members can also access the My Dental Benefits tool on our Web site (www.UnitedConcordia.com) to view their benefits and eligibility information, claim details, procedure history, maximum and deductible accumulations, and more. Plus, United Concordia Dental’s responsive customer service representatives are available to assist members with questions regarding their benefits. Our Utilization Review area also analyzes thousands of claims each year to ensure the acceptability of treatment and quality of services. And, our Dental Advisors and consultants continuously review dentists’ fees and practice patterns for statistical variation from their peers. Dentists who fall outside of the norm are targeted for education and additional monitoring.

Western Dental: Providers are bound by contract to accept the member’s schedule of benefits.

8. How many provider locations do you have?

Aetna: As of 5/1/10

DMO – 48,270 dentist locations nationally and 7,328 in Calif.
PPO – 131,004 dentist locations nationally and 25,364 in Calif.

Aflac: We do not have network requirements. Policyholders may visit any
provider they choose.

Ameritas/FDH Network: 37,022 Calif. provider access points,

(23,852 Ameritas; 13,170 FDH); 21,972 Calif. locations, (16,399 Ameritas; 5,573 FDH)
Anthem Blue Cross: As of 04/30/2010
California Dental Blue PPO locations:
Dental Blue 100 about 18,734
Dental Blue 200 about 20,466
Dental Blue 300 about 21,373
Prudent Buyer 18,915
DHMO locations: more than 5,000 in California

BEN-E-LECT: Our dental plans utilize the Smart Health (Interplan), First Health (CCN) and Western Dental networks, which contain thousands of offices statewide.

BEST Health Plans: In Calif., we contract with 7,828 providers.

Blue Shield: Members have network access to over 8,000 HMO and 20,000 PPO providers in Calif.,
and nearly 110,000 providers nationwide.

CIGNA: Nationally we have more than 47,000 DHMO contracted access points and more than 167,400 DPPO Radius Network contracted access points. In Calif. we have more than 10,200 DHMO contracted access points and more than 31,200 DPPO Radius Network contracted access points. CIGNAPlus Savings (dental discount card, not insurance) includes more than 121,500 of our DPPO contracted access points.

Dearborn National: Dearborn National has the largest PPO network of dental access points nationwide offering over 150,000 access points for our members to chose from.

Delta Dental: In Calif., Delta Dental Premier, 33,600, Delta Dental
PPO, 20,700, and DeltaCare USA (DHMO), 4,200. We also give our enrollees access to the national Delta Dental networks.

Dental Health Services: Our network of participating dentists consists of nearly 800 general practice offices with 2,698 participating dentists, and an additional 1,751 specialists. Our PPO network carries more than 16,000 dentists.

Golden West: Our National WellPoint PPO Network contracts with over 79,000 providers. Our DHMO network has over 14,700 statewide participating providers.

Guardian: There are over 131,500 PPO dentist-locations across the country and more than 22,000 in Calif. We are the largest PPO network in the state based on unique dentists. Guardian recently purchased the Preferred Dental Network in Nevada and is no longer leasing access to the Diversified network. For the DHMO, there are 10,730 locations across the country and 4,854 in Calif.

Health Net Dental: As of May 2010, our California PPO network includes 23,988 access points in 8,438 locations. Our California DHMO network includes 2,677 locations.

HumanaDental: Our dental PPO network is one of the largest in California, which encourages dentists to participate in our network, enabling us to negotiate attractive dental fee schedules. We have a PPO network with more than 27,000 dentist locations in California, and continue to grow daily. Almost 99% of the dentists who join our network stay in our network. Also, HumanaDental has a unique recruiting campaign targeting all dentists used by employees.

MetLife: As of May, our Dental PPO network includes over 135,000 participating dentist locations nationwide (12% growth from 2009), including over 22,800 in Calif. And, the Dental HMO network includes more than 13,000 participating dentist locations in Calif., Fla. and Texas (18% growth from 2009), including over 6,900 in Calif., over 4,000 in Fla. and over 2,100 in Texas.

Principal Financial Group: We have approximately 25,500 PPO provider locations and 14,000 EPO provider locations.

Securian Dental: 87,000 dentist access points.

United Concordia Dental: We have more than 69,000 dentists at nearly 112,000 practicing locations nationwide in our Advantage Plus PPO network. In Calif. alone, we have more than 13,100 dentists at over 29,600 total locations. Our DHMO network includes more than 2,600 primary dental offices and 1,500 specialists nationwide, with over 1,500 primary dental offices and 590 specialists in Calif.

Western Dental: Our provider network is unique among DMO carriers because it has over 220 Western Dental Centers (staff model) in addition to more than 1, 000 IPA offices with more than 2500 dentists.

9. Can Insureds change providers easily if they are unhappy?

Aetna: Yes, members in our PPO/indemnity plan can change any time and do not need to notify us. Members in our DMO plan can choose a new provider as often as once per month through Navigator, our online web tool for members, or by calling the toll-free telephone number on the back of their ID card.

Aflac: Yes. Policyholders can change providers at any time.

Ameritas PPO and the FDH Networks: Insureds can choose any provider at any time for procedures.

Anthem Blue Cross: Dental Blue PPO members can visit any licensed dentist and will normally have more cost-savings when services are completed by a Dental Blue provider. There is no gatekeeper for the dental Blue PPO dental plans. The same is true for our traditional Prudent Buyer dental PPO plans. The DHMO members can change providers once a month.

BEN-E-LECT: Yes, members may change providers at any time by selecting to use another provider. No further documentation or process in necessary. Freedom pre-paid Dental is the only plan in which a member would select a specific provider.

BEST Health Plans: Members may request another network provider on a monthly basis. Members can request a provider change online or by calling Member Services. Requests must be made by the 25th of the month to become effective on the 1st of the following month.

Blue Shield: Yes, DPPO members may change providers at any time without notice. DHMO members may change in-network dentists on a monthly basis; requests made by the 10th of the month become effective the first of the following month.

CIGNA: Yes, the DPPO/DEPO/indemnity plans allow individuals to change dentists whenever they want. No call is necessary. DHMO enrollees can easily change their primary-care dentist online via myCIGNA.com – our secure website. They can also use our automated Quick Transfer option, or simply call customer service. The change is effective on the first day of the month following the date they make the change. The CIGNAFlex Advantage feature provides individuals the flexibility to switch monthly between DHMO and DPPO or indemnity plans, depending on the plan design options chosen by the employer.

Dearborn National: In our PPO dental plan, members can see any dentist they like, whether in-network or out-of-network. However greater savings are gained by utilizing network dentists.

In the DHMO plan, members must select a dentist that is in the network.

Delta Dental: Fee-for-service enrollees can change dentists any time without notifying us. DHMO enrollees can change their contract dentist by contacting customer service or online at www.deltadentalins.com. Requests submitted prior to the 21st of each month are effective the first of the following month.

Dental Health Services: Members can change their dentist at any time by contacting their Member Service Specialist by calling 800-637-6453 or online at www.dentalhealthservices.com.

Golden West: DHMO members can change their providers once a month by calling our member services department and requesting the change. In addition, members are allowed up to three dental offices per family unit. For the PPO plan, members choose their dental office from a list of participating providers through our Website or their own (non-contract) provider.

Guardian: Members covered under Guardian’s PPO plans can change dentists at will, regardless of whether the dentists are participating or non-participating. Members covered under our DHMO plan may change dentists by using our on-line web tool, GuardianAnytime.com, or by calling our toll-fee number. Requests made by the 20th of the month are effective the first of the following month. We also offer a dual choice monthly switch plan, which enables members to switch between the DHMO and PPO as often as desired on a monthly basis.

Health Net Dental: With our PPO plan design, there is no need to select a primary care dentist or to obtain referrals for specialty care. Under our DHMO plans, members may change their primary care dentists once a month by calling Health Net Dental Member Services or via our on-line Web portal. The change is effective the first of the month, provided that the request is made by the 20th of the previous month.

HumanaDental: With the PPO plan design, the member can change dentists without notifying the dental plan.

MetLife: With our Dental PPO benefit plans, there is no need to select a primary care dentist or get referrals for specialty care. For the Dental HMO, a member can easily change their selected dentist online or by calling customer service.

Principal Financial Group: Yes.

Securian Dental: Yes.

United Concordia Dental: Yes, members can change PPO providers at any time without notice. DHMO participants may change dentists by writing or calling customer service and requesting a new DHMO provider, as long as there is no existing balance due to the current dentist or treatment in progress.

Western Dental: Our membership can change providers, on a monthly basis, by phone or in writing.