DELTA DENTAL OFFERS A CLEAR PRESENTATION OF COVERED SERVICES, LIMITATIONS AND EXCLUSIONS

We believe that our consumers and subscribers have a right to clear and complete information about their dental benefits. As a result, we provide information that fully explains their benefits as well as any limitations or exclusions of services in easy-to- understand language.

DELTA DENTAL MAKES DENTAL SERVICES READILY AVAILABLE
We inform subscribers about Delta Dental's network of participating dentists and explain the advantages of receiving treatment from these plan providers. In addition, subscribers are also informed about services provided by licensed practitioners not participating with Delta Dental. This information explains that, since the fees of these nonparticipating dentist are not subject to contractual controls, subscribers may have higher out-of-pocket costs.

In our managed care programs, Delta Dental provides listings of participating dentists to help in subscribers' selection of a dentist. Subscribers' rights to access emergency care and regular appointments, as well as professionally sound treatment, are protected in these programs as fully as in all our other Delta Dental benefit programs.

DELTA DENTAL OFFERS ACCESS TO SPECIALTY CARE
Benefits for professionally-indicated specialist treatment are covered by Delta Dental programs. Our fee-for-service program (Delta Dental Premier) offers our groups access to a nationwide network of participating dentists specializing in pediatric care, oral and maxillofacial surgery, endodontics, periodontics, oral pathology, prosthodontics and orthodontics. Delta Dental also believes that subscribers of managed care programs should have access to specialists, and our programs include a process of such referrals.

DELTA DENTAL GIVES CONSUMERS ACCESS TO EMERGENCY CARE
Delta Dental recognizes that there can be dental conditions which, if left untreated, could result in serious dental impairment or continued severe pain. In such cases, all of Delta Dental's programs provide coverage for emergency dental treatment. In addition, dentists in Delta Dental's managed care programs are required to provide 24-hour, on-call arrangements for such emergencies.

DELTA DENTAL BELIEVES CHOICE OF BENEFIT PROGRAMS IS IMPORTANT
Delta Dental has a comprehensive selection of program designs available for its group purchasers to enable them to select the program or combination of programs that best meets the needs of their workforces. Regardless of whether traditional or managed care designs are chosen, the structure of every Delta Dental program assures subscribers access to professionally sound and proper benefit service.

DELTA DENTAL SUPPORTS DISCLOSURE OF PATIENT OPTION IN DENTAL TREATMENT (NO GAG RULES PERMITTED)
There are a variety of professionally-sound treatment options for many dental conditions. Dentists under contract to Delta Dental recognize their obligation to discuss these options with their patients, thoroughly explaining the benefits available for each, as well as the level of patient participation required in the cost of care. Delta Dental endorses this practice and never restricts dentists from openly discussing such treatment options with their patients.

In addition, in cases where there is uncertainty regarding the level of patient participation in the cost of care, dentists are encouraged to submit claims to Delta Dental for predetermination. Through this process, both the dentist and the patient can receive detailed information from us about covered services and costs before treatment is provided.

DELTA DENTAL HAS A SYSTEM TO RESOLVE COMPLAINTS AND APPEALS
We support the rights of patients who believe a dental claim is unfair to have access to a prompt and fair review and appeal process. We maintain formal and informal complaint resolution systems that subscribers and dentists may use when there is a disagreement over coverage or concerns about quality of care. Both systems are designed to ensure that coverage is administered in accordance with accepted dental practice standards as well as the group contract.

DELTA DENTAL SUPPORTS AND COMPLIES WITH STATE REGULATORY PROTECTIONS
Delta Dental recognizes the importance of local government regulation to provide protection of consumers against benefit plan abuse. Delta Dental supports and complies with state statutes and regulations, as well as those of the U.S. Department of Labor's Employee Retirement Income Security Act. We also believe that, long term, the single most effective protection of consumers' rights is market competition. Plans that are inadequately funded and administered and/or fail to meet consumers' needs will not survive in the marketplace.

DELTA DENTAL IS COMMITTED TO SAFEGUARDING PATIENT INFORMATION
Delta Dental believes in a patient's right to privacy with regard to his/her records and dental history. We also support the right of an individual to access his/her records and information pertaining to claims submitted for care and services. In accordance with current federal and state regulations, Delta Dental strives to protect this information and allow access to confidential records to the limited parties necessary for treatment purposes, patient's knowledge, claim needs and/or as legally required.

DELTA DENTAL ENCOURAGES CONSUMER INVOLVEMENT BENEFIT PLAN POLICY
Delta Dental is committed to consumer participation in the development and refinement of the policies for our programs. To this end, the governing bodies of all Delta Dental Plans include representatives from the business and dentist communities, as well as our consumers. Such involvement assures that the needs of those we cover are met both in the design and the administration of our programs to foster improved dental health.

DELTA DENTAL BELIEVES CONSUMERS OF DENTAL PLANS ALSO HAVE RESPONSIBILITIES
Improved oral health is a primary objective of Delta Dental, but it can only be achieved with the cooperation of the individuals covered by our programs. It is each individual's responsibility to engage in a dental health program that includes a regimen of personal dental hygiene, self-examination and regular professional care. Avoidance of substances and behaviors that place oral health in jeopardy should also be a component of each individual's personal care.

We believe it is also the responsibility of our consumers to become familiar with their specific plan's coverage; meet any financial obligation incurred as a result of treatment, including paying the appropriate copayments or deductibles required by the plan; and cooperate with their dentist on treatment plans to achieve a satisfactory result.

The programs Delta Dental offers, by emphasizing regular, preventive care, are structured to encourage those covered to fulfill their responsibilities, primarily through regular, preventive care. In addition, Delta Dental provides informational materials that can assist covered individuals in achieving optimum oral health by utilizing their program effectively.

If you require any additional information E-mail your questions to Delta Dental of Illinois.