Dental Care Benefits

2009 RATES	Total Cost	Employer Monthly	Employee Monthly	Employee Biweekly
Employee	$ 28.49	$ 22.79	$ 5.70	$ 2.63
Family	$ 74.84	$ 55.38	$ 19.46	$ 8.98

2008 RATES	Total Cost	Employer Monthly	Employee Monthly	Employee Biweekly
Dental Basic
Employee	$27.54	$22.03	$5.51	$2.54
Family	$72.46	$53.62	$18.84	$8.70
Dental Plus
Employee	$40.48	$22.03	$18.45	$8.51
Family	$103.34	$53.62	$49.72	$22.95

2008 DENTAL BENEFITS SUMMARY

Dental Basic:

• Preventive Services are paid at 100%
• Basic Services are paid at 80%
• Major Services are paid at 60%
• Orthodontics is paid at 60% with a $1,250 per person lifetime maximum.
• There is a $1,000 annual program maximum per covered person with a $25 deductible per person and $50 deductible per family.*
• Implant coverage is paid at 60% up to $1,000 annual maximum
• Fluoride treatments for participants up to age 19.**

Dental Plus:***

• Preventive Services are paid at 100%
• Basic Services are paid at 100%
• Major Services are paid at 80%
• There is a $1,000 annual maximum per covered person with a $25 deductible per person and $50 deductible per family. *
• Implant Coverage is paid at 60% with a $1,000 annual maximum.
• Orthodontics is paid at 60% with a $2,500 per person lifetime maximum.
• Fluoride treatments for participants up to age 19.**

* Deductibles are waived for services from network providers and percentages are applied to agreed reimbursement rates. Non-network reimbursements are based on the stated percentage of the maximum allowable charges.

**When appropriate, coverage for prescription fluoride treatment is available through your Penn State health plan. Coverage applies at the retail level from your local pharmacy as well as from your mail-order maintenance drug plan. Additional information is available in United Concordia's Adult Fluoride Treatment FAQs.

***Dental Plus is not open for new enrollment and will end on December 31, 2008.

You may access a list of participating providers from the UCCI website. You can locate participating providers in Centre County from the Nittany Dental Network.

A predetermination of benefits permits a review of a proposed treatment in advance and allows for resolution of any questions before, rather than after, the work has been done. Additionally, both you and the dentist will know in advance, rather than after, the coverage and estimated benefit. A predetermination should be requested when the total charges will be $300 or more.

2009 DENTAL BENEFIT SUMMARY