Group Dental Plan Proposal

Transcription

1 Group Dental Plan Proposal Plan Highlights Voluntary or employer paid Rates as low as $10.75 a month Large statewide network of providers No waiting periods on any benefits Orthodontic (braces) for children & adults Plan provided by: Beta Health Association, Inc. Dental Plan Specialists since 1990

2 Attached please find our formal dental proposal. We appreciate the opportunity you have given us to present our dental plan for your consideration. The plan administrator is Beta Health Association, Inc. (BHA). BHA has been a leader in providing both voluntary and employer paid dental benefits in Colorado since They still represent over 94% of their original clients. There are over 92,000 members and 4,200 employer groups enrolled in a BHA dental program throughout Colorado! Our new dental product line is a perfect fit for your group. Each of the employees would be able to select from a certified and credentialed network of dentists that consists of over 500 dentists across Colorado including the Western Slope. This is by far the largest network of this type here in Colorado. The highlights of this plan are: Can be offered on a totally voluntary or employer paid basis. Rates are reduced is it is employer paid on the single rate. Rates are as low as $10.75 a month for an employee and only $30.75 a month for a family. Specific rates by location are included in this proposal for your review. Only one employee needs to participate. Normal voluntary participation is approximately 60% even if the employee is paying the full monthly cost. Employees want and need a dental plan! No waiting periods on any benefits (even major work or orthodontics) Unlimited benefits each year. Employees and their dependents can use the plan as much as they like each year. Employees will save an average of 65% off of the dentist s normal full fee. The plan will pay for itself in the benefit cost savings if they just have their cleanings done each year. Spanish speaking enrollment material is also available Certified and credentialed dentists statewide. 98% of all enrolled members would recommend the plan to a friend or neighbor and 91% stay with the first dentist they select! We are very confident that this new dental plan will provide you with a quality product for your employees and their dependents. Your employees would greatly appreciate you making this plan available to them as they would love to save some cost on their dental expenses every year! Sincerely, Rocky Mountain Health Plans Marketing Department

3 Who is Beta Health Association, Inc.? Beta Health Association, Inc. (BHA) is a Colorado based dental carrier which has specialized in both voluntary (employee paid) and contributory (employer paid) dental products since We also have a great individual dental product which is available on a national basis. Our Corporate Office is located in Denver, Colorado with Regional Marketing Offices in Grand Junction and Pueblo. Current membership is approximately 92,000 members. Company History and Product Line At first, BHA was designed to market and administer only a singular product line the Alpha Dental Plan. This plan is a discount fee-for-service network dental plan which is offered on a group and individual basis. Over the next 16 years, our company grew to include the administration and marketing of an additional discount fee-for-service network dental plan, which is called the CarePOS product. This product offers our members the flexibility of seeing one of over 33,000 national dental providers in 48 states. We also offer a host of indemnity and PPO dental plans where our members can visit any dentist, which was created through marketing alliances between BHA, Securian Dental, Companion Life, and AIG. These three indemnity products can be purchased separately or can be combined with the Alpha and CarePOS dental plans to create our group Triple Choice Dental Plan product. This product line does not require any employer contribution and allows each employee the choice between three different dental plan options i.e. the Alpha Dental Colorado Network Plan, the CarePOS Dental National Network Plan, or the Securian Dental, Companion Life, or AIG Dental Plan where they can see any dentist. Throughout our history, we have remained steadfast in our focus in offering high quality products and exceptional service to all of our members. BHA is operated on a daily basis by a wellseasoned and experienced management team. Even after a substantial amount of growth over the years, our company retains the feeling of a hometown, privately owned and operated business. A collection of supremely committed, qualified and conscientious dental plan experts, the BHA team has earned the trust and respect of countless members, participating dentists, and insurance agents across Colorado and the nation. We have proven our competency and demonstrated our skills. Each employee at BHA shares the same focus on delivering superior service and contributes daily to the same purpose of maintaining high quality, high value dental products for all participants. We are truly the Dental Plan Specialists in Colorado!

4 A company is known by the company it keeps Here are some of the over 4,200 Beta Health Association, Inc. clients Capco, Inc. Weld County Lehrer s Flowers The City of Greeley Colorado Materials Palace Construction The Pueblo Chieftain Union Printers Home O Meara Ford Center El Pueblo Boys Ranch Iliff School of Theology Hospital Shared Services Burt Automotive Network The University of Denver Rocky Mountain Materials Moreland Automotive Group Columbine Health Management Colorado Springs Health Partners Rocky Mountain Motorists (AAA) Lower Valley Hospital Association 11 th Judicial District-District Attorney s Office Colorado Association of Non-Profit Organizations (CANPO)

5 What are the low monthly rates? Front Range Voluntary Employer Paid Employee only $11.25 $10.75 Employee and one dependent $21.25 $20.75 Employee and two or more dependents $31.25 $30.75 Rate guarantee: 2 years 3 years Western Slope Voluntary Employer Paid Employee only $12.25 $11.75 Employee and one dependent $24.50 $24.00 Employee and two or more dependents $35.50 $35.00 Rate guarantee: 2 years 3 years Important guidelines: The employer paid rates are based upon the group contributing a minimum of 100% of the single employee only rate. The above rates apply only to non-current Beta Health Association, Inc. clients.

6 Dental Plan Highlights Large statewide network of dentists to select from Cosmetic dentistry included No waiting on any services.ever! Orthodontics (braces) discounted for children and adults No forms to complete No age limits for members No limit on visits No exclusions for dental health conditions No limits on access to discounts (use as much as you like each year) The enclosed fee schedule represents the pre-negotiated discounts we have arranged in advance with the General Dentists who are participating in the plan. Simply pay these amounts directly to your participating dentist at the time services are rendered it s that easy!

7 Beta Health Association Inc. Marketing Fee Schedule Alpha #19 June 1, 2006 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION NORMAL FEE ALPHA PLAN #19 YOU SAVE Diagnostic Services (Exams and X-rays) 999 ROUTINE OFFICE VISIT $ 35 $ 5 86% 120 PERIODIC ORAL EVALUATION $ 49 No Cost 100% 140 LIMITED ORAL EVALUATION-PROBLEM FOCUSED $ 73 $ 14 81% 150 COMPREHENSIVE ORAL EVALUATION-NEW OR ESTABLISHED PATIENT $ 88 $ 11 87% 210 X-RAY INTRAORAL COMPLETE SERIES INC. BITEWINGS $ 122 $ 26 79% 220 X-RAY INTRAORAL-PERIAPICAL-FIRST FILM $ 28 $ 6 79% 230 X-RAY INTRAORAL PERIAPICAL EACH ADDITIONAL FILM $ 22 $ 4 80% 240 X-RAY INTRA ORAL-OCCLUSAL FILM $ 42 $ 4 89% 250 X-RAY EXTRAORAL-FIRST FILM $ 70 $ 4 94% 260 X-RAY EXTRAORAL-EACH ADDITIONAL FILM $ 53 $ 4 92% 270 X-RAY BITEWING-SINGLE FILM $ 28 No Cost 100% 272 X-RAY BITEWING-2 FILMS $ 42 No Cost 100% 274 X-RAY BITEWING-4 FILMS $ 60 No Cost 100% 330 X-RAY PANORAMIC FILM $ 105 $ 44 58% 340 CEPHALOMETRIC FILM $ 127 $ 56 56% 460 PULP VITALITY TEST $ 55 No Cost 100% 470 DIAGNOSTIC CASTS $ 106 $ 42 60% 999 EMERGENCY VISIT (SAME DAY) $ 90 $ 25 72% Preventive Services (Cleanings) 1110 PROPHYLAXIS-ADULT CLEANING (EVERY 6 MONTHS) $ 89 $ 15 83% 1120 PROPHYLAXIS-CHILD CLEANING (EVERY 6 MONTHS) $ 66 $ 15 77% 1203 TOPICAL APPLICATION OF FLUORIDE NOT INCL/PROPHY-CHILD $ 37 $ 11 71% 1330 ORAL HYGIENE INSTRUCTIONS $ 53 No Cost 100% 1351 SEALANT PER TOOTH $ 53 $ 11 79% 1510 SPACE MAINTAINER FIXED UNILATERAL $ 312 $ % 1515 SPACE MAINTAINER FIXED BILATERAL $ 423 $ % 1520 SPACE MAINTAINER-REMOVABLE-UNILATERAL $ 381 $ % 1525 SPACE MAINTAINER-REMOVABLE-BILATERAL $ 478 $ % 1550 RE-CEMENTATION OF SPACE MAINTAINER $ 80 $ 15 81% 1999 ADDITIONAL PROPHY (FOR PERIO MAINTENANCE) $ 89 $ 38 57% Restorative Services (Fillings, Crowns, Inlays and Onlays) 2140 AMALGAM-1 SURFACE (PRIMARY OR PERMANENT) $ 132 $ 29 78% 2150 AMALGAM-2 SURFACES (PRIMARY OR PERMANENT) $ 169 $ 38 77% 2160 AMALGAM-3 SURFACES (PRIMARY OR PERMANENT) $ 206 $ 48 77% 2161 AMALGAM-4 OR MORE SURFACES (PRIMARY OR PERMANENT) $ 238 $ 55 77% 2330 RESIN BASED COMPOSITE 1 SURFACE (ANTERIOR) $ 153 $ 41 73% 2331 RESIN BASED COMPOSITE 2 SURFACES (ANTERIOR) $ 194 $ 53 73% 2332 RESIN BASED COMPOSITE 3 SURFACES (ANTERIOR) $ 238 $ 69 71% 2335 RESIN 4 OR MORE SURFACES OR INVOLVING INCISAL ANGLE (ANTERIOR) $ 290 $ % 2390 RESIN BASED COMPOSITE CROWN ( ANTERIOR) $ 435 $ % 2391 RESIN BASED COMPOSITE ONE SURFACE (POSTERIOR) $ 169 $ 88 48% 2392 RESIN BASED COMPOSITE TWO SURFACE (POSTERIOR) $ 221 $ % 2393 RESIN BASED COMPOSITE THREE SURFACE (POSTERIOR) $ 276 $ % 2394 RESIN BASED COMPOSITE FOUR OR MORE SURFACES (POSTERIOR) $ 330 $ % *2510 INLAY-METALLIC-ONE SURFACE $ 823 $ % *2520 INLAY-METALLIC-TWO SURFACE $ 823 $ % *2530 INLAY-METALLIC-THREE OR MORE SURFACES $ 904 $ % *2542 ONLAY-METALLIC-TWO SURFACES $ 933 $ % *2543 ONLAY-METALLIC-THREE SURFACES $ 979 $ % *2544 ONLAY-METALLIC-FOUR OR MORE SURFACES $ 876 $ % *2610 INLAY-PORCELAIN/CERAMIC-ONE SURFACE $ 900 $ % *2650 INLAY-RESIN BASED COMPOSITE-ONE SURFACE $ 841 $ % *2651 INLAY-RESIN BASED COMPOSITE-TWO SURFACES $ 849 $ % *2652 INLAY-RESIN BASED COMPOSITE-THREE OR MORE SURFACES $ 889 $ % *2710 CROWN-RESIN BASED COMPOSITE (INDIRECT) $ 858 $ % *2720 CROWN-RESIN WITH HIGH NOBLE METAL $ 985 $ % *2721 CROWN-RESIN WITH PREDOMINANTLY BASE METAL $ 950 $ % *2722 CROWN RESIN WITH NOBLE METAL $ 952 $ % *2740 CROWN PORCELAIN/CERAMIC SUBSTRATE $ 1,058 $ % *2750 CROWN PORCELAIN FUSED TO HIGH NOBLE METAL $ 1,042 $ % *2751 CROWN-PORCELAIN FUSED TO PREDOMINANTLY BASE METAL $ 961 $ % *2752 CROWN-PORCELAIN FUSED TO NOBLE METAL $ 1,005 $ % Current Dental Terminology American Dental Association Page 1

8 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION NORMAL FEE ALPHA PLAN #19 YOU SAVE Restorative Services (Fillings, Crowns, Inlays and Onlays) Con't *2790 CROWN FULL CAST HIGH NOBLE METAL $ 1,005 $ % *2791 CROWN FULL CAST PREDOMINANTLY BASE METAL $ 929 $ % *2792 CROWN FULL CAST NOBLE METAL $ 976 $ % 2910 RECEMENT INLAY, ONLAY, OR PARTIAL COVERAGE RESTORATION $ 102 $ 13 88% 2920 RECEMENT CROWN $ 104 $ 28 73% 2930 PREFAB. STAINLESS STEEL CROWN-PRIMARY $ 265 $ 92 65% 2931 PREFAB STAINLESS STEEL CROWN-PERMANENT $ 323 $ % 2932 PREFAB. RESIN CROWN $ 344 $ % 2933 PREFAB. STAINLESS STEEL CROWN WITH RESIN WINDOW $ 358 $ % 2940 SEDATIVE FILLING $ 110 $ 31 72% 2950 CORE BUILDUP INCLUDING ANY PINS $ 265 $ 75 72% 2951 PIN RETENTION PER TOOTH IN ADD. TO RESTORATION $ 74 $ 21 71% 2952 CAST POST & CORE IN ADDITION TO CROWN $ 423 $ % 2954 PREFAB POST & CORE IN ADDITION TO CROWN $ 330 $ 96 71% 2955 POST REMOVAL (NOT IN CONJUNCTION WITH ENDODONTIC THERAPY) $ 300 $ % 2960 LABIAL VENEER RESIN LAMINATE (CHAIRSIDE) $ 661 $ % 2999 BLEACHING (PER ARCH) $ 260 $ % 2999 $125 ADDTL.CHARGE P/UNIT FOR MULTIPLE CROWN UNITS/COMPLEX REHABILITATION *These co-payments do not include an allowable $138 lab fee (per unit). Doctors, please make sure that all members understand what their fees will be and what the savings are from your Usual and Customary fees. Temporary crowns are included with permanent crown preparation. Endodontic Services (Root Canals) 3110 PULP CAP DIRECT EXCLUDING FINAL RESTORATION $ 83 $ 24 72% 3120 PULP CAP INDIRECT EXCLUDING FINAL RESTORATION $ 85 $ 25 71% 3220 THERAPEUTIC PULPOTOMY EXCLUDING FINAL RESTORATION $ 196 $ 65 67% 3230 PULPAL THERAPY ANTERIOR, PRIMARY TOOTH EXCLUDING REST. $ 275 $ 86 69% 3240 PULPAL THERAPY POSTERIOR, PRIMARY TOOTH EXCLUDING REST $ 317 $ 96 70% 3310 ROOT CANAL THERAPY 1 CANAL (EXCLUDING FINAL RESTORATION) $ 671 $ % 3320 ROOT CANAL THERAPY 2 CANALS (EXCLUDING FINAL RESTORATION) $ 783 $ % 3330 ROOT CANAL THERAPY 3 CANALS OR MORE $ 952 $ % 3410 APICOECTOMY/PERIRADICULAR SURGERY-ANTERIOR $ 671 $ % 3421 APICOECTOMY/PERIRADICULAR SURGERY-BICUSPID (FIRST ROOT) $ 733 $ % 3425 APICOECTOMY/PERIRADICULAR SURGERY-MOLAR (FIRST ROOT) $ 863 $ % 3426 APICOECTOMY/PERIRADICULAR SURGERY-EACH ADDITIONAL ROOT $ 397 $ % 3430 RETROGRADE FILLING-PER ROOT $ 291 $ % 3910 SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM $ 248 $ 57 77% Periodontic Services (Gum Disease) 4210 GINGIVOPLASY OR GIGIVECTOMY- 4+ CONTIGUOUS OR BOUNDED SP. TEETH P/QUAD $ 635 $ % 4211 GINGIVECTOMY OR GINGIVOPLASTY-1 TO 3 CONTIGUOUS OR BOUNDED SP. TEETH P/QUAD $ 265 $ % 4240 GINGIVAL FLAP PROCEDURE, INCL.ROOT PLNG -4+ CONTIG. OR BOUNDED SP. TEETH P/QUAD $ 741 $ % 4260 OSSEOUS SURG. INCL. FLAP ENTRY & CLOSURE-4+ CONTIG. OR BOUNDED SP. TEETH P/QUAD $ 1,032 $ % 4320 PROVISIONAL SPLINTING-INTRACORNIAL $ 529 $ % 4321 PROVISIONAL SPLINTING-EXTRACORNIAL $ 487 $ % 4341 PERIODONTAL SCALING & ROOT PLNG- 4+ TEETH PER QUAD $ 240 $ % 4355 FULL MOUTH DEBRIDEMENT TO ENABLE COMP.EVAL. & DIAGNOSIS $ 185 $ 83 55% 4910 PERIODONTAL MAINTENANCE $ 135 $ 53 61% 4999 PERIO SCREENING AND SCORING $ 30 $ 10 67% Prosthodontics (Removable/Complete Dentures, etc.) 5110 COMPLETE DENTURE-MAXILLARY $ 1,600 $ % 5120 COMPLETE DENTURE-MANDIBULAR $ 1,661 $ % 5130 IMMEDIATE DENTURE-MAXILLARY $ 1,738 $ % 5140 IMMEDIATE DENTURE-MANDIBULAR $ 1,744 $ % 5211 MAXILLARY PART. DENTURE-RESIN BASE (INCL. CLASPS & TEETH) $ 1,270 $ % 5212 MANDIBULAR PARTIAL DENTURE-RESIN BASE (INCL. CLASPS & TEETH) $ 1,323 $ % 5213 MAXILLARY PART. DENT.-CST MTL FRMEWRK W/RESIN DENT. BASE (INCL/CLASPS & TEETH) $ 1,720 $ % 5214 MANDIBULAR PART. DENT.-CST MTL FRMEWRK W/RESIN DENT. BASE (INCL/CLASPS & TEETH) $ 1,720 $ % 5410 ADJUST COMPLETE DENTURE-MAXILLARY $ 86 $ 32 63% 5411 ADJUST COMPLETE DENTURE-MANDIBULAR $ 85 $ 32 63% 5421 ADJUST PARTIAL DENTURE-MAXILLARY $ 85 $ 32 63% 5422 ADJUST PARTIAL DENTURE-MANDIBULAR $ 85 $ 32 63% 5510 REPAIR BROKEN COMPLETE DENTURE BASE $ 200 $ 76 62% 5520 REPLACE MISSING OF BROKEN TEETH-COMP.DENTURE-EACH TOOTH $ 180 $ 57 68% 5610 REPAIR RESIN DENTURE BASE $ 202 $ 74 63% 5620 REPAIR CAST FRAMEWORK $ 286 $ % 5630 REPAIR OR REPLACE BROKEN CLASP $ 265 $ 97 63% 5640 REPLACE BROKEN TEETH-PER TOOTH $ 181 $ 62 66% 5650 ADD TOOTH TO EXISTING PARTIAL DENTURE $ 216 $ 83 62% 5660 ADD CLASP TO EXISTING PARTIAL DENTURE $ 268 $ % Current Dental Terminology American Dental Association Page 2

9 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION NORMAL FEE ALPHA PLAN #19 YOU SAVE Prosthodontics (Removable/ Complete Dentures, etc.) Con't 5710 REBASE COMPLETE MAXILLARY DENTURE $ 561 $ % 5711 REBASE COMPLETE MANDIBULAR DENTURE $ 561 $ % 5720 REBASE MAXILLARY PARTIAL DENTURE $ 542 $ % 5721 REBASE MANDIBULAR PARTIAL DENTURE $ 546 $ % 5730 RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE) $ 370 $ % 5731 RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE) $ 370 $ % 5740 RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE) $ 367 $ % 5741 RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE) $ 370 $ % 5750 RELINE COMPLETE MAXILLARY DENTURE (LABORATORY) $ 462 $ % 5751 RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY) $ 462 $ % 5760 RELINE MAXILLARY PARTIAL DENTURE (LABORATORY) $ 450 $ % 5761 RELINE MANDIBULAR PARTIAL DENTURE (LABORATORY) $ 450 $ % 5850 TISSUE CONDITIONING MAXILLARY $ 202 $ 57 72% 5851 TISSUE CONDITIONING MANDIBULAR $ 205 $ 57 72% NOTE: In addition to the fees listed above in section 5000 thru 6000, additional fees may be charged for upgraded teeth and enhanced cosmetics, personalization beyond norm or techniques involving precision dentures. Prosthodontics (fixed/partialdentures, etc.) *6210 PONTIC-CAST HIGH NOBLE METAL $ 1,016 $ % *6211 PONTIC-CAST PREDOMINANTLY BASE METAL $ 952 $ % *6212 PONTIC-CAST NOBLE METAL $ 979 $ % *6240 PONTIC-PORCELAIN FUSED TO HIGH NOBLE METAL $ 1,032 $ % *6241 PONTIC-PORCELAIN FUSED TO PREDOMINANTLY BASE METAL $ 961 $ % *6242 PONTIC-PORCELAIN FUSED TO NOBLE METAL $ 995 $ % *6250 PONTIC-RESIN WITH HIGH NOBLE METAL $ 995 $ % *6251 PONTIC-RESIN WITH PREDOMINANTLY BASE METAL $ 955 $ % *6252 PONTIC-RESIN WITH NOBLE METAL $ 979 $ % *6720 CROWN-RESIN WITH HIGH NOBLE METAL $ 1,032 $ % *6721 CROWN-RESIN WITH PREDOMINANTLY BASE METAL $ 952 $ % *6722 CROWN-RESIN WITH NOBLE METAL $ 990 $ % *6750 CROWN-PORCELAIN FUSED TO HIGH NOBLE METAL $ 1,042 $ % *6751 CROWN-PORCELAIN FUSED TO PREDOMINANTLY BASE METAL $ 959 $ % *6752 CROWN-PORCELAIN FUSED TO NOBLE METAL $ 1,004 $ % *6790 CROWN-FULL CAST HIGH NOBLE METAL $ 1,004 $ % *6791 CROWN-FULL CAST PREDOMINANTLY BASE METAL $ 952 $ % *6792 CROWN-FULL CAST NOBLE METAL $ 1,000 $ % 6930 RECEMENT FIXED PARTIAL DENTURE $ 171 $ 64 63% These co-payments do not include an allowable $138 lab fee (per unit). Doctors, please make sure that all members understand what their fees will be and what the savings are from your Usual and Customary fee. Oral Surgery (Extractions, etc.) 7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL) $ 159 $ 39 75% 7210 SURGICAL EXT. ERUPTED TOOTH WITH REMOVAL OF BONE $ 265 $ 72 73% 7220 REMOVAL OF IMPACTED TOOTH-SOFT TISSUE $ 307 $ 82 73% 7230 REMOVAL OF IMPACTED TOOTH PARTIALLY BONY $ 386 $ % 7240 REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY $ 476 $ % 7241 REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY W/ UNUSUAL SURG. COMPLICATION $ 566 $ % 7250 SURGICAL REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE) $ 309 $ % 7270 TOOTH REIMPL. AND/OR STAB. OF ACC.EVULSED OR DISPL. TOOTH $ 540 $ % 7280 SURGICAL ACCESS OF AN UNERUPTED TOOTH $ 479 $ % 7285 BIOPSY OF ORAL TISSUE-HARD (BONE-TOOTH) $ 409 $ % 7286 BIOPSY OF ORAL TISSUE-SOFT $ 316 $ % 7310 ALVEOPLASTY IN CONJ. WITH EXT.- PER QUAD $ 289 $ % 7320 ALVEOPLASTY NOT IN CONJ WITH EXT- PER QUAD $ 471 $ % 7510 INCISION AND DRAINAGE ABSCESS- INTRAORAL SOFT TISSUE $ 222 $ 86 61% 7910 SUTURE OF RECENT SMALL WOUNDS UP TO 5CM $ 317 No Cost 100% 7960 FRENULECTOMY (FRENECTOMY OR FRENOTOMY)- SEPARATE PROCEDURE $ 442 $ % 7970 EXCISION OF HYPERPLASTIC TISSUE- PER ARCH $ 524 $ % General Miscellaneous Services 9110 EMERGENCY PALATIVE TREATMENT OF DENTAL PAIN- MINOR PROCEDURE $ 123 $ 43 65% 9230 ANALGESIA, ANXIOLYSIS, INHALATION OF NITROUS OXIDE - FIRST 30 MINUTES $ 79 $ 22 72% 9310 CONSULTATION (DIAG. SERV. PROV. BY DENTIST OR PHYSICIAN OTHER THAN PRACTIONER PROV. TREATMNT) $ 141 No Cost 100% 9910 APPLICATION OF DESENSITIZING MEDICAMENT $ 66 $ 5 92% 9941 FABRICATION OF ATHLETIC MOUTHGUARD $ 282 $ 96 66% 9951 OCCLUSAL ADJUSTMENT-LIMITED $ 185 $ 67 64% 9952 OCCLUSAL ADJUSTMENT-COMPLETE $ 670 $ % 9999 MISSED APPOINTMENT (WITHOUT 24 HOUR NOTICE) $ 54 $ 30 44% Current Dental Terminology American Dental Association Page 3

10 ADA CODE DENTAL PROCEDURE/ADA CODE DESCRIPTION NORMAL FEE ALPHA PLAN #19 YOU SAVE Orthodontics (Braces) for Children & Adults Monthly Payment 13 MONTH TREATMENT PLAN ($125/MONTH) $ 2,852 $ 2,200 23% 16 MONTH TREATMENT PLAN ($125/MONTH) $ 3,320 $ 2,575 22% 19 MONTH TREATMENT PLAN ($125/MONTH) $ 3,787 $ 2,950 22% 22 MONTH TREATMENT PLAN ($125/MONTH) $ 4,218 $ 3,325 21% 25 MONTH TREATMENT PLAN ($125/MONTH) $ 4,724 $ 3,700 22% 28 MONTH TREATMENT PLAN ($125/MONTH) $ 5,192 $ 4,075 22% 31 MONTH TREATMENT PLAN ($125/MONTH) $ 5,659 $ 4,450 21% 34 MONTH TREATMENT PLAN ($125/MONTH) $ 6,127 $ 4,825 21% 36 MONTH TREATMENT PLAN ($125/MONTH) $ 6,439 $ 5,075 21% Other Orthodontic Guidelines 1. A $350 charge will apply at the end of treatment (included in the above amounts) to cover all retention office visits (unlimited). 2. Services not listed above will be discounted 30% off of the participating Orthodontist's Usual and Customary fees (except #5 listed below). 3. Services must only be provided by a contracted Orthodontic Specialist. 4. The amounts listed above also include an initial one-time $225 charge for all records, mold, x-rays, etc. to determine the Orthodontic Treatment for the patient. 5. Invisalign procedures are to be discounted 15% off the participating Orthodontist's Usual and Customary fees. All Plans General Limitations and Exclusions 1. All fees listed above do not include all appropriate lab fees. Member must agree (in writing) to all upgraded materials before treatment is started. See each section for specific details (if applicable). 2. All patients are responsible for paying all fees (as listed above) at the time services are rendered. 3. These fees are for General Dentists only. A participating specialist list is available by calling our office at or Any procedures not listed will be discounted 20% off the participating General Dentists normal fees. 5. Medical costs associated with any dental procedures are not covered. 6. Dentures or appliances will be replaced only after 3 years have elapsed since such dentures or appliances were provided under any plan program, unless the denture or appliance becomes unserviceable due to illness or other causes not controlled by other means. Replacement of dentures, appliances, or bridgework due to loss or theft are not covered. 7. Any dental treatment started prior to the Member's eligibility to receive services under this plan or started after a Member's termination are not covered. 8. Failure to follow the prescribed treatment or accidents occurring during the course of treatment may result in additional charges by your plan provider. 9. Failure to pay scheduled fees at the time service is rendered may prevent future dental services from being received until all fees have been paid in full. 10. Services provided by non-participating dentists are not covered. 11. Services which, in the opinion of the attending dentist, are not necessary for the patient's dental health, or are contrary to established dental ethics are not covered. 12. Cosmetic dental procedures are covered only if the attending dentist and patient agree on the specific procedure. 13. Services which are compensable under Worker's Compensation or employer liability laws are not covered. 14. General anesthesia and IV sedation are not covered. 15. Myofunctional therapy procedure for training, treating or developing muscles in and around the jaw or mouth including TMJ are not covered except by participating plan specialists. 16. Any dental procedure or service that cannot be performed in the dental office due to general and/or physical limitations of a member are not covered. 17. Expenses incurred for dental procedures initiated prior to member's eligibility or after termination are not covered. 18. Any services that the Participating General Dentist recommends be performed by a specialist are covered only by a plan participating specialist. 19. The liability of Beta Health Association, Inc. is limited to the return of the membership fee's paid for one year by the member. 20. Extractions for asymptomatic third molars (wisdom teeth) are not covered unless causing movement of the teeth. An example of symptomatic include severe decay, and ontogenic cysts, chronic pericoronitis, and infection. 21. The Beta Health Association, Inc. dental programs do not constitute dental insurance and are considered discount, fee-forservice dental plans. 22. Fees are subject to change on an as needed basis. Please contact Beta Health Association, Inc. for current fees. Current Dental Terminology American Dental Association Page 4

11 Our Contracted Providers Are Proven Professionals! We are known by the quality of our contracted dentists Beta Health Association has developed network relationships with some of the finest dentists in the cities and suburbs where our members live and work. Our reputation depends on dentists who are dedicated to providing quality services Beta Health Association believes that the single most important consideration of our provider network is quality dental care. The key to quality dental care is the building of dental networks that allow for the convenience of location, adequate appointment availability, band the availability of a wide selection of private practice dentists who are committed to establishing a positive patient/ dentist relationship. We use high standards to select our dentists All participating Family Dentists and Specialists are subject to a credentialing process to ensure their qualifications meet our high standards. The program provides that Beta Health Association should: Perform background checks with the State Board of Dental Examiners We believe that the single most important consideration of our provider network is quality dental care Validate proof of current dental license Validate proof of current DEA and Radiology Certification where applicable Validate proof of professional liability insurance Review information regarding any past malpractice history, including past or present license sanctions

12 Proven Professionals Page 2 Practice standards set us apart Our experienced provider relations staff goes to great lengths to carefully measure all elements of a dental practice, including the following: The overall attitude and demeanor of the office staff Accessibility, including: parking, waiting room, and appointment availability The office follows established infection control procedures, and is compliant with OSHA standards The dental equipment is state of the art A patient recall system is in place to encourage preventive dental care Adequate record keeping and patient health history to encourage quality care Accessibility of Dental Services Access to emergency treatment, 7 days a week, 24 hours a day Routine appointments generally available within 5 to 6 weeks Family Dentists with office hours at least 3 days per week Multilingual and after-hour capabilities by some Family Dentists are available More than you might expect Admittedly, few patients ever scrutinize a dental provider the way we do. And our interest in customer service extends to the area of member satisfaction, with regular evaluations of selected dental offices and the care received there. We randomly survey our members to determine how our program is performing, not from our standpoint but from their standpoint. These results are currently as follows: 94.3% feel as though they receive good to excellent care 97.3% are satisfied with the scheduling of their first appointment 96.8% would recommend our plan to their friends and family members 91% of our members stay with the first dentist they select when they enroll

13 Alpha Dental Plan Complete Provider Directory 10/20/2006 Complete Participating Provider Directory (For Alpha Dental Plan ) Statewide Telephone number PLEASE NOTE: UNDER THE PROVIDER COLUMN THE ADP # IS FOR ALPHA DENTAL PLAN 19 AND A. (Providers are listed in alphabetical order according to city) NAME OFFICE NAME PROVIDER ADDRESS PHONE CITY SPECIALTY CODES Richard Williams Dr. Richard Williams ADP # Edison Alamosa General Dentist *, **, C, E1-2, E3-4, N Howard Stringert Dr. Howard Stringert Not Needed 511 Main St Alamosa Orthodontist None Kathy Tomlinson Comfort Dental - North Arvada ADP # W. 80th Ave Arvada General Dentist *, **, C, E1-2, E3-4, N Juan Materon Comfort Dental - North Arvada ADP # W. 80th Ave Arvada General Dentist *, **, C, E1-2, E3-4, N Shayna Barr Comfort Dental - North Arvada ADP # W. 80th Ave Arvada General Dentist *, **, C, E1-2, E3-4, N Anita Vedi New Impressions Dental ADP # W. 88th Ave Arvada General Dentist **, C, E1-2 M. Scott Peppler New Impressions Dental ADP # W. 88th Ave Arvada General Dentist **, C, E1-2 Alan Bueltel Comfort Dental - Arvada ADP # W. 64th Ave Arvada General Dentist *, C, E1-2, E3-4, N Neil Zimmet Comfort Dental - Arvada ADP # W. 64th Ave Arvada General Dentist *, C, E1-2, E3-4, N Mark Dean Comfort Dental - Arvada ADP # W. 64th Ave Arvada General Dentist *, C, E1-2, E3-4, N James R. Mayo Comfort Dental - Arvada ADP # W. 64th Ave Arvada General Dentist *, C, E1-2, E3-4, N Damon C. WIlkerson Colo Orthodontics Not Needed 6390 Gardenia St., # Arvada Orthodontist None James H. Mason Colo Orthodontics Not Needed 6390 Gardenia St., # Arvada Orthodontist None John Bailey Colo Orthodontics Not Needed 6390 Gardenia St., # Arvada Orthodontist None Roy Theriot Dr. Roy Theriot ADP # S. Havana, # Aurora General Dentist *, C Matthew Snyder Bright Now Dental - Smoky Hill ADP # Prospect Ave., Ste. HV2BE Aurora General Dentist *, C, E1-2, E3-4 Charles Stirewalt Bright Now Dental - Smoky Hill ADP # Prospect Ave., Ste. HV2BE Aurora General Dentist *, C, E1-2, E3-4 Kris Komanduri Hanu Dental Care ADP # E. Mississippi Ave., #1 W Aurora General Dentist *, **, C, E1-2, E3-4 Steven Perry Dental Health Center ADP # S. Sable Aurora General Dentist *, **, C, E1-2, E3-4 Saadia Basit Dental Health Center ADP # S. Sable Aurora General Dentist *, **, C, E1-2, E3-4 Frank Weir Dental Health Center ADP # S. Sable Aurora General Dentist *, **, C, E1-2, E3-4 Matthew Rowan Comfort Dental - Aurora ADP # S. Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Jeffrey Gilliam Comfort Dental - Aurora ADP # S. Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Zachary D. Bergeson Comfort Dental - Aurora ADP # S. Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Gerald Edwards Comfort Dental - Aurora ADP # S. Peoria Aurora General Dentist *, **, C, E1-2, E3-4, N Scott Henderson Comfort Dental - Orchard Rd. ADP # E. Orchard Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Jeffrey Hamilton Comfort Dental - Orchard Rd. ADP # E. Orchard Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Michael Gioia Comfort Dental - Orchard Rd. ADP # E. Orchard Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Lorraine Loustalet Comfort Dental - East Aurora ADP # S. Chambers Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Jeffrey A. Varner Comfort Dental - East Aurora ADP # S. Chambers Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Sean Phelan Comfort Dental - East Aurora ADP # S. Chambers Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Jim Parfitt Comfort Dental - East Aurora ADP # S. Chambers Rd Aurora General Dentist *, **, C, E1-2, E3-4, N Jeffrey A. Ranta Wohlgemuth & Rush, DDS ADP # S. Havana, # Aurora General Dentist C, N Steven Rush Wohlgemuth & Rush, DDS ADP # S. Havana, # Aurora General Dentist C, N Barry Wohlgemuth Wohlgemuth & Rush, DDS ADP # S. Havana, # Aurora General Dentist C, N Robert Browning Robert Browning, DDS ADP # E. Mississippi Ave., # Aurora General Dentist *, C, E1-2, E3-4 Thomas E. Daniel Dr. Thomas E. Daniel ADP # Havana Aurora General Dentist C Page 1 of 7

14 Alpha Dental Plan Complete Provider Directory 10/20/2006 NAME OFFICE NAME PROVIDER ADDRESS PHONE CITY SPECIALTY CODES Michael Buchler Blue Mesa Dental - S. Chambers Rd. ADP # S. Chambers Rd Aurora General Dentist **, C, E1-2, E3-4 Robert Utberg Bright Now Dental - S. Tower Rd. ADP # S. Tower Rd., #C Aurora General Dentist *, **, C, E1-2 James E. Berwick Bright Now Dental - S. Tower Rd. ADP # S. Tower Rd., #C Aurora General Dentist *, **, C, E1-2 Charles Stirewalt Bright Now Dental - S. Tower Rd. ADP # S. Tower Rd., #C Aurora General Dentist *, **, C, E1-2 James Lui Comfort Dental - Quincy & Buckley ADP # E. Quincy D1-D Aurora General Dentist **, C, E1-2, N John W. Thousand, III Comfort Dental - Quincy & Buckley ADP # E. Quincy D1-D Aurora General Dentist **, C, E1-2, N Nicole Ward Comfort Dental - Quincy & Buckley ADP # E. Quincy D1-D Aurora General Dentist **, C, E1-2, N Camillo DiLizia Comfort Dental - Quincy & Buckley ADP # E. Quincy D1-D Aurora General Dentist **, C, E1-2, N James H. Mason Colo Orthodontics Not Needed 2993 S. Peoria St., # Aurora Orthodontist None John Bailey Colo Orthodontics Not Needed 2993 S. Peoria St., # Aurora Orthodontist None Damon C. WIlkerson Colo Orthodontics Not Needed 2993 S. Peoria St., # Aurora Orthodontist None Hilary Neilberg-Baskin Comfort Smile Center Not Needed E. Hampden Ave Aurora Orthodontist None Jack E. Duran Dr. Jack E. Duran Not Needed E. Mississippi Ave., Unit #1 N Aurora Orthodontist None Roy M. Lorenz Roy M. Lorenz, DMD, MS Not Needed E. Hampden Ave. # Aurora Orthodontist None Theresa Shaver Theresa Shaver Orthodontics, PC Not Needed E. Iliff, # Aurora Orthodontist None Damon C. WIlkerson University of Colorado Department of Orthodontics Not Needed 1635 N. Ursula St Aurora Orthodontist None Voytek Bobak Dr. Voytek Bobak Not Needed 460 County Rd Bailey Orthodontist None Wojciech Bobak Dr. Wojciech Bobak Not Needed 460 County Rd Bailey Orthodontist None Sharon Poczatek Todays Choice Dental ADP # Valmont Rd Boulder General Dentist *, **, C, E1-2, E3-4 Lisa Sheldon Comfort Dental - Boulder ADP # Arapahoe Rd Boulder General Dentist *, C, E1-2, E3-4 April Sousa Comfort Dental - Boulder ADP # Arapahoe Rd Boulder General Dentist *, C, E1-2, E3-4 Christopher Mehlhoff Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Charles Stirewalt Bright Now Dental - Boulder ADP # Folsom St Boulder General Dentist *, C, E1-2, E3-4 Mary Connolly Dental Health Center ADP # th St., # Boulder General Dentist *, **, C, E1-2, E3-4 Allen Skromme Dental Health Center ADP # th St., # Boulder General Dentist *, **, C, E1-2, E3-4 Steven Perry Dental Health Center ADP # th St., # Boulder General Dentist *, **, C, E1-2, E3-4 Steven J. Hood Dental Health Center ADP # th St., # Boulder General Dentist *, **, C, E1-2, E3-4 John Walker Dr. John Walker Not Needed 350 Broadway # Boulder Orthodontist None Cindy Sue Wilson Cindy Sue Wilson, D.D.S. ADP #14 80 Garden Center North D Broomfield General Dentist C, E1-2 Lyndon Mata Mata Dental ADP # W. 120th Ave., # Broomfield General Dentist *, C, E1-2, N Charles Stirewalt Bright Now Dental - Castle Rock ADP # S. Perry St., #105-A Castle Rock General Dentist **, C Joseph Feller Bright Now Dental - Castle Rock ADP # S. Perry St., #105-A Castle Rock General Dentist **, C Jason Ray Blue Mesa Dental - Southglenn ADP # E. Easter Ave., # Centennial General Dentist C, E1-2, E3-4 Richard Handelman Blue Mesa Dental - Southglenn ADP # E. Easter Ave., # Centennial General Dentist C, E1-2, E3-4 Jeanette Berner Comfort Dental - Centennial ADP # S. Quebec St., Unit A Centennial General Dentist *, C, E1-2, E3-4 Scott H. Ash Comfort Dental - Centennial ADP # S. Quebec St., Unit A Centennial General Dentist *, C, E1-2, E3-4 Jacqueline Blasko Comfort Dental - Centennial ADP # S. Quebec St., Unit A Centennial General Dentist *, C, E1-2, E3-4 Richard W. Arbuckle Reliable Dental ADP # Bent Brothers Blvd. #D Colorado City General Dentist C, E1-2 Richard H. Wiedey Dr. Richard H. Wiedey ADP # North Circle # Colorado Springs General Dentist **, E1-2, E3-4, N Michael Stoor Comfort Dental - Citadel Crossing ADP # N. Academy Blvd Colorado Springs General Dentist *, C, E1-2 John Rollow, IV Comfort Dental - Citadel Crossing ADP # N. Academy Blvd Colorado Springs General Dentist *, C, E1-2 Dwight Douglas Olson Comfort Dental - North Powers ADP # Stetson Hills Blvd Colorado Springs General Dentist *, **, C, E1-2, E3-4 Andrew Killgore Comfort Dental - North Powers ADP # Stetson Hills Blvd Colorado Springs General Dentist *, **, C, E1-2, E3-4 Steve Carter Comfort Dental - North Powers ADP # Stetson Hills Blvd Colorado Springs General Dentist *, **, C, E1-2, E3-4 Michael D. Millward Bright Now Dental - Parkmoor Village ADP # N. Academy Blvd., # Colorado Springs General Dentist C, E1-2, E3-4 Charles Stirewalt Bright Now Dental - Parkmoor Village ADP # N. Academy Blvd., # Colorado Springs General Dentist C, E1-2, E3-4 Kathleen Brower Jade Dental Professionals South ADP # S. Academy Blvd., # Colorado Springs General Dentist C, E1-2 Page 2 of 7

15 Alpha Dental Plan Complete Provider Directory 10/20/2006 NAME OFFICE NAME PROVIDER ADDRESS PHONE CITY SPECIALTY CODES Joseph A. Woods Blue Mesa Citadel Dental, PC ADP # Citadel Dr. East # Colorado Springs General Dentist *, C, E1-2 Richard Handelman Blue Mesa Citadel Dental, PC ADP # Citadel Dr. East # Colorado Springs General Dentist *, C, E1-2 Paul Rygg Stafford Dental Group ADP # E. Pikes Peak Ave., # Colorado Springs General Dentist **, E1-2, E3-4 Leopoldo Rodríguez Leopoldo Rodríguez ADP # N. Academy Blvd., # Colorado Springs General Dentist C, E1-2 Paul Hennegan Bright Now Dental - Citadel Dr. ADP # Citadel Dr. East Colorado Springs General Dentist **, C, E1-2, E3-4 Charles Stirewalt Bright Now Dental - Citadel Dr. ADP # Citadel Dr. East Colorado Springs General Dentist **, C, E1-2, E3-4 Benjamin Butler Bright Now Dental - Citadel Dr. ADP # Citadel Dr. East Colorado Springs General Dentist **, C, E1-2, E3-4 Curtis Broeker Premier Dentistry ADP # Erindale Dr. # Colorado Springs General Dentist *, C, E1-2, E3-4 Julia Arnold Interquest Dental Group, Inc. ADP # United Heights Dr. # Colorado Springs General Dentist C Paul Rodríguez Dr. Paul Rodríguez ADP # N. Tejon St., #D Colorado Springs General Dentist **, C, E1-2, E3-4 Steven Castillo Castillo Dental Associates ADP # Vindicator Dr., # Colorado Springs General Dentist C, E1-2, E3-4 Colleen Jenson Jade Dental Associates ADP # N. Tejon St., #A Colorado Springs General Dentist C, E1-2, E3-4 Natalie Jones Comfort Dental - North Academy ADP # York Rd Colorado Springs General Dentist *, C, E1-2, E3-4, N Rick Christensen Comfort Dental - North Academy ADP # York Rd Colorado Springs General Dentist *, C, E1-2, E3-4, N Steven Krendl Comfort Dental - North Academy ADP # York Rd Colorado Springs General Dentist *, C, E1-2, E3-4, N Daniel Ward Comfort Dental - North Academy ADP # York Rd Colorado Springs General Dentist *, C, E1-2, E3-4, N David Schroeder Apple Orthodontics Not Needed 1694 E. Cheyenne Mtn. Blvd Colorado Springs Orthodontist None Louis Talmoumis Apple Orthodontics Not Needed 1694 E. Cheyenne Mtn. Blvd Colorado Springs Orthodontist None Scott Sutter Front Range Ortho Not Needed 3100 N. Academy Blvd., # Colorado Springs Orthodontist None Voytek Bobak Dr. Voytek Bobak Not Needed Pleasant Park Rd., #B Conifer Orthodontist None Wojciech Bobak Dr. Wojciech Bobak Not Needed Pleasant Park Rd., #B Conifer Orthodontist None Robert Unrath Comfort Dental - North Denver ADP # W. 38th Ave Denver General Dentist *, **, C, E1-2, E3-4 James Li-Hang Liu Comfort Dental - North Denver ADP # W. 38th Ave Denver General Dentist *, **, C, E1-2, E3-4 Tom Marschner Comfort Dental - North Denver ADP # W. 38th Ave Denver General Dentist *, **, C, E1-2, E3-4 Gary Saddler Comfort Dental - North Denver ADP # W. 38th Ave Denver General Dentist *, **, C, E1-2, E3-4 Alan Coombs Alpha Dental II, PC ADP # S. Albion, # Denver General Dentist ** Norris Sadler Dr. Norris Sadler ADP # W. 38th Ave Denver General Dentist *, E1-2, E3-4, N Thomas Sniegowski Dr. Thomas Sniegowski ADP # Dakin St., Ste. # Denver General Dentist *, E1-2 Dr. Mayya Acherkan Affordable Dental Care ADP # S. Federal Blve Denver General Dentist **, E1-2, E3-4 Stephen Brown Affordable Dental Care ADP # S. Federal Blve Denver General Dentist **, E1-2, E3-4 Makala Bannister Dental Health Center ADP # Stout St., # Denver General Dentist *, C, E1-2 Steven Perry Dental Health Center ADP # Stout St., # Denver General Dentist *, C, E1-2 Karen Suchyta Dental Health Center ADP # Franklin St., # Denver General Dentist *, **, C, E1-2, E3-4, N Amir Hashemi Dental Health Center ADP # Franklin St., # Denver General Dentist *, **, C, E1-2, E3-4, N Steven Perry Dental Health Center ADP # Franklin St., # Denver General Dentist *, **, C, E1-2, E3-4, N David Dinsmore Comfort Dental - Cherry Creek ADP # University Blvd., # Denver General Dentist *, C, E1-2, E3-4 Todd Light Comfort Dental - Cherry Creek ADP # University Blvd., # Denver General Dentist *, C, E1-2, E3-4 Mark Jolested Comfort Dental - Cherry Creek ADP # University Blvd., # Denver General Dentist *, C, E1-2, E3-4 Donald Mardis Comfort Dental - East Colfax ADP # E. Colfax Ave Denver General Dentist *, **, C, E1-2 Gary Rotolo Comfort Dental - East Colfax ADP # E. Colfax Ave Denver General Dentist *, **, C, E1-2 Thomas Pyne Dr. Thomas Pyne ADP # E. 45th Ave., # Denver General Dentist *, C, E1-2, E3-4 Charles Stirewalt Bright Now Dental - Denver Downtown ADP # Arapahoe St., Ste. A Denver General Dentist C, E1-2, E3-4 Christina Lee Dental Health Center ADP # S. Ulster St., # Denver General Dentist **, C Donald Langley Dental Health Center ADP # S. Ulster St., # Denver General Dentist **, C Joseph Feller Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr. North, # Denver General Dentist C, N Charles Stirewalt Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr. North, # Denver General Dentist C, N Thomas Borris Bright Now Dental - Cherry Creek ADP # Cherry Creek Dr. North, # Denver General Dentist C, N Page 3 of 7

16 Alpha Dental Plan Complete Provider Directory 10/20/2006 NAME OFFICE NAME PROVIDER ADDRESS PHONE CITY SPECIALTY CODES David R. Huskey David R. Huskey, DDS ADP # S. Downing, #104 A Denver General Dentist C, E1-2, N Timothy Wachuta Dr. Timothy Wachuta ADP # S. Colorado Blvd Denver General Dentist C, E1-2, E3-4 Kenneth Chernoff Dr. Timothy Wachuta ADP # S. Colorado Blvd Denver General Dentist C, E1-2, E3-4 Ekatrina Butkevich Dr. Timothy Wachuta ADP # S. Colorado Blvd Denver General Dentist C, E1-2, E3-4 Greg Schlagel AAA Dental Center ADP # Newton St Denver General Dentist **, E1-2, E3-4 Kelly White Auraria Dental Centre ADP # W. Colfax, Ste. G Denver General Dentist **, E1-2, E3-4 Paul Rocke Downtown Orthodontics Not Needed 1050 W. Colfax, Ste. G Denver Orthodontist None Michael D. Bellon Dr. Michael D. Bellon Not Needed 7200 E. Hampden, # Denver Orthodontist None Neil Cowen Dr. Neil Cowen ADP # S. Lafayette, Suite Englewood General Dentist *, C, E1-2 David Rebber Comfort Dental - Englewood ADP # S. Broadway Englewood General Dentist *, C, E1-2, E3-4, N Larry Nessel Comfort Dental - Englewood ADP # S. Broadway Englewood General Dentist *, C, E1-2, E3-4, N Jeffrey Spiegel Comfort Dental - Englewood ADP # S. Broadway Englewood General Dentist *, C, E1-2, E3-4, N William Case Dr. William Case ADP # E. Orchard Rd., # Englewood General Dentist *, C Jennifer Mansky Blue Mesa Dental - S. Quebec ADP # S. Quebec, #A Englewood General Dentist C, E1-2, E3-4 David Richter Dr. David Richter - Englewood Not Needed 5031 S. Ulster St., # Englewood Orthodontist None Jack E. Duran Orthodontics Exlusively Not Needed 3601 S. Clarkson Englewood Orthodontist None King Campbell Comfort Dental - Ft. Collins ADP # S. Lemay Fort Collins General Dentist *, C, E1-2, E3-4, N Douglas Haschke Comfort Dental - Ft. Collins ADP # S. Lemay Fort Collins General Dentist *, C, E1-2, E3-4, N Matthew Draper Comfort Dental - Ft. Collins ADP # S. Lemay Fort Collins General Dentist *, C, E1-2, E3-4, N Alois Tripam Comfort Dental - Ft. Collins ADP # S. Lemay Fort Collins General Dentist *, C, E1-2, E3-4, N Charles Stirewalt Bright Now Dental - Fort Collins ADP # E. Elizabeth St., # Fort Collins General Dentist C, E1-2 James E. Berwick Bright Now Dental - Fort Collins ADP # E. Elizabeth St., # Fort Collins General Dentist C, E1-2 Joseph Feller Bright Now Dental - Fort Collins ADP # E. Elizabeth St., # Fort Collins General Dentist C, E1-2 Scott Novak Bright Now Dental - Fort Collins ADP # E. Elizabeth St., # Fort Collins General Dentist C, E1-2 William W. Iversen Dr. William W. Iversen Not Needed 1103 S. Shields Fort Collins Orthodontist None Thomas L. Losacco Dr. Thomas L. Losacco ADP # th St Georgetown General Dentist *, C, E1-2, E3-4, N Robert A. Woods Glenwood Meadows Dental ADP # A Market Street Glenwood Springs General Dentist **, C, E1-2, E3-4 William McGlashan Comfort Dental - Glenwood Springs ADP # Grand Ave Glenwood Springs General Dentist *, **, C, E1-2, E3-4 Michael Shea Comfort Dental - Glenwood Springs ADP # Grand Ave Glenwood Springs General Dentist *, **, C, E1-2, E3-4 Timothy Wachuta Dr. Timothy Wachuta ADP # Jackson St Golden General Dentist C, E1-2, E3-4 Kenneth Chernoff Dr. Timothy Wachuta ADP # Jackson St Golden General Dentist C, E1-2, E3-4 Ekatrina Butkevich Dr. Timothy Wachuta ADP # Jackson St Golden General Dentist C, E1-2, E3-4 Michael Miller Golden View Dental ADP # Simms St., #E Golden General Dentist *, C, E1-2 Joe Taylor Golden View Dental ADP # Simms St., #E Golden General Dentist *, C, E1-2 Paulette Dilizia Comfort Dental - Golden ADP # S. Golden Rd Golden General Dentist *, **, C, E1-2, E3-4 Eric Morrison Comfort Dental - Golden ADP # S. Golden Rd Golden General Dentist *, **, C, E1-2, E3-4 Christine M. Isaacs Comfort Dental - Golden ADP # S. Golden Rd Golden General Dentist *, **, C, E1-2, E3-4 James M. Tarr Dr. James M. Tarr ADP # W. Pinyon Ave Grand Junction General Dentist C, E1-2 Robert R. Harmen Denture Depot ADP # N. 1st St., Unit D Grand Junction General Dentist *, C Brad Nelson Grand Valley Family Dental ADP # Walnut Ave., # Grand Junction General Dentist C, E1-2 T. Allan Hymas Mesa Orthodontics Not Needed 1190 Bookcliff, Ave., Ste Grand Junction Orthodontist None Steven Perry Dental Health Center ADP # rd Ave., # Greeley General Dentist *, C, E1-2, E3-4, N Charles Johnson Dental Health Center ADP # rd Ave., # Greeley General Dentist *, C, E1-2, E3-4, N Randy Hatch Dental Health Center ADP # rd Ave., # Greeley General Dentist *, C, E1-2, E3-4, N Stephen Brown Dr. Stephen Brown ADP # W. 16th St., Bldg. 3, Ste. S Greeley General Dentist **, E1-2 Patrick Rinaldis Comfort Dental - Greeley ADP # West 10th St Greeley General Dentist *, **, C, E1-2, E3-4 Courtney Stevens Comfort Dental - Greeley ADP # West 10th St Greeley General Dentist *, **, C, E1-2, E3-4 Page 4 of 7

17 Alpha Dental Plan Complete Provider Directory 10/20/2006 NAME OFFICE NAME PROVIDER ADDRESS PHONE CITY SPECIALTY CODES Patrick Harrison Sunrise Dental Center ADP # A. St Greeley General Dentist *, **, C, E1-2, E3-4 Kent Day Sunrise Dental Center ADP # A. St Greeley General Dentist *, **, C, E1-2, E3-4 Alex Knecht Sunrise Dental Center ADP # A. St Greeley General Dentist *, **, C, E1-2, E3-4 Shivaun McArtor Sunrise Dental Center ADP # A. St Greeley General Dentist *, **, C, E1-2, E3-4 Dinorah Moya Sunrise Dental Center ADP # A. St Greeley General Dentist *, **, C, E1-2, E3-4 David Richter Dr. David Richter Not Needed rd Ave., # Greeley Orthodontist None Gary Barth Dr. Gary Barth Not Needed th Ave. Ct Greeley Orthodontist None John C. Gentile Front Range Orthodontic Specialists Not Needed th Ave., #D Greeley Orthodontist None David Richter West Greeley Orthodontics Not Needed 7251 W. 20th St Greeley Orthodontist None Michael Vetowich Comfort Dental - Highlands Ranch ADP # W. County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Christopher Hasselback Comfort Dental - Highlands Ranch ADP # W. County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Mark Jolested Comfort Dental - Highlands Ranch ADP # W. County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Michael Love Comfort Dental - Highlands Ranch ADP # W. County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Khiem Hoang Comfort Dental - Highlands Ranch ADP # W. County Line Rd Highlands Ranch General Dentist *, **, C, E1-2, E3-4 Joseph Feller Bright Now Dental - Highlands Ranch ADP # Highlands Rnch. Pkwy # Highlands Ranch General Dentist **, C Brian S. Gurinsky Bright Now Dental - Highlands Ranch ADP # Highlands Rnch. Pkwy # Highlands Ranch General Dentist **, C Dwight M. Bratton Bright Now Dental - Highlands Ranch ADP # Highlands Rnch. Pkwy # Highlands Ranch General Dentist **, C Rhett M. Quist Bright Now Dental - Highlands Ranch ADP # Highlands Rnch. Pkwy # Highlands Ranch General Dentist **, C Charles Stirewalt Bright Now Dental - Highlands Ranch ADP # Highlands Rnch. Pkwy # Highlands Ranch General Dentist **, C Christopher Baer Bright Now Dental - Highlands Ranch ADP # Highlands Rnch. Pkwy # Highlands Ranch General Dentist **, C Bryan Nelson Dr. Bryan Nelson Not Needed 9567 S.University Blvd., #C-1A Highlands Ranch Orthodontist None Paul Rocke Front Range Ortho Not Needed 7901 S. Park Plaza, # Highlands Ranch Orthodontist None Howard Stringert Dr. Howard Stringert Not Needed 313 W. 3rd St., # La Junta Orthodontist None Hanaa Jebril Comfort Dental - Lafayette ADP # W. South Boulder Rd., # Lafayette General Dentist *, **, C, E1-2, E3-4 Vien Tran Comfort Dental - Lafayette ADP # W. South Boulder Rd., # Lafayette General Dentist *, **, C, E1-2, E3-4 Efren Martinez Dr. Efren Martinez ADP # S. Wadsworth Lakewood General Dentist **, E1-2, E3-4 Richard Glucksman Alpha Dental XX ADP # W. Jefferson, # Lakewood General Dentist C Puja Taneja Bright Now Dental - Lakewood ADP # W. Colfax Ave., #D Lakewood General Dentist *, C James H. Mason Colo Orthodontics Not Needed W. Jewell Ave., #B Lakewood Orthodontist None John Bailey Colo Orthodontics Not Needed W. Jewell Ave., #B Lakewood Orthodontist None Damon C. WIlkerson Colo Orthodontics Not Needed W. Jewell Ave., #B Lakewood Orthodontist None Voytek Bobak Dr. Voytek Bobak Not Needed 1840 S. Wadsworth Blvd Lakewood Orthodontist None Wojciech Bobak Dr. Wojciech Bobak Not Needed 1840 S. Wadsworth Blvd Lakewood Orthodontist None Andrey Nazarov Front Range Ortho Not Needed 7125 W. Jefferson, # Lakewood Orthodontist None Zachery Bacus Highplains Community Health Center ADP # Kendall Drive Lamar General Dentist **, C, E1-2 Ibraheem Ackall Highplains Community Health Center ADP # Kendall Drive Lamar General Dentist **, C, E1-2 Bill Bender Dr. Bill Bender ADP # nd St Lasalle General Dentist *, **, C, E1-2 Thomas Klumb Comfort Dental - Littleton ADP # W. Coal Mine Ave Littleton General Dentist *, C, E1-2, E3-4 Bill Oldershaw Comfort Dental - Littleton ADP # W. Coal Mine Ave Littleton General Dentist *, C, E1-2, E3-4 Brad Weekes Comfort Dental - Littleton ADP # W. Coal Mine Ave Littleton General Dentist *, C, E1-2, E3-4 Steven Echols Belleview Dental Associates ADP # W. Belleview Littleton General Dentist * Ellias Najjar Belleview Dental Associates ADP # W. Belleview Littleton General Dentist * Margareta Pavel Dutch Creek Dental ADP # W. Coal Mine Ave., # Littleton General Dentist *, C, E1-2, E3-4 Hilary Neilberg-Baskin Comfort Smile Center Not Needed 5055 S. Kipling Pkwy Littleton Orthodontist None Michael D. Bellon Dr. Michael D. Bellon Not Needed 7325 S. Pierce St., # Littleton Orthodontist None Robert B. Gardner Dr. Robert B. Gardner Not Needed 9878 W. Belleview Ave Littleton Orthodontist None Voytek Bobak Dr. Voytek Bobak Not Needed 5728 S. Gallup St Littleton Orthodontist None Page 5 of 7

18 Alpha Dental Plan Complete Provider Directory 10/20/2006 NAME OFFICE NAME PROVIDER ADDRESS PHONE CITY SPECIALTY CODES Wojciech Bobak Dr. Wojciech Bobak Not Needed 5728 S. Gallup St Littleton Orthodontist None Paul Rocke Front Range Orthodontic Not Needed 200 West County Line Rd., # Littleton Orthodontist None David Albert Personalized Orthodontic Not Needed 7889 S. Lincoln Ct., # Littleton Orthodontist None Eunic P. Lee SouthPark Orthodontics Not Needed 8199 South Park Lane # Littleton Orthodontist * Amir R. Fereydouni SouthPark Orthodontics Not Needed 8199 South Park Lane # Littleton Orthodontist * Jason Ray Blue Mesa Dental - Lone Tree ADP # Park Meadows Dr. #B Lone Tree General Dentist C, E1-2, E3-4 Richard Handelman Blue Mesa Dental - Lone Tree ADP # Park Meadows Dr. #B Lone Tree General Dentist C, E1-2, E3-4 Matthew Draper Comfort Dental - Longmont ADP # Mountain View Longmont General Dentist *, **, C, E1-2, E3-4 Jolly Johnson Comfort Dental - Longmont ADP # Mountain View Longmont General Dentist *, **, C, E1-2, E3-4 Steven Perry Dental Health Center ADP # S. Hover Rd., #H Longmont General Dentist *, C, E1-2, E3-4 Ronald Magnuson Dental Health Center ADP # S. Hover Rd., #H Longmont General Dentist *, C, E1-2, E3-4 Robert Hamblin Dental Health Center ADP # S. Hover Rd., #H Longmont General Dentist *, C, E1-2, E3-4 Stephen Brown Affordable Dental Clinic ADP # Terry St Longmont General Dentist *, E1-2 John Weber Comfort Dental - Louisville ADP # McCaslin Blvd., #B Louisville General Dentist *, **, C, E1-2, E3-4, N Kelvin Webster Comfort Dental - Louisville ADP # McCaslin Blvd., #B Louisville General Dentist *, **, C, E1-2, E3-4, N Jonathan Weinbach Smile Zone Orthodontics Not Needed 1075 S. Boulder Rd., # Louisville Orthodontist None Ciaran Finbar Murphy Bright Now Dental - Loveland ADP # W. 29th St., # Loveland General Dentist **, E1-2 Charles Stirewalt Bright Now Dental - Loveland ADP # W. 29th St., # Loveland General Dentist **, E1-2 J. Kallio Comfort Dental - Thompson Valley ADP # th St. S.W Loveland General Dentist C, E1-2, N King Campbell Comfort Dental - Thompson Valley ADP # th St. S.W Loveland General Dentist C, E1-2, N Douglas Haschke Comfort Dental - Thompson Valley ADP # th St. S.W Loveland General Dentist C, E1-2, N K. Sorensen Comfort Dental - Thompson Valley ADP # th St. S.W Loveland General Dentist C, E1-2, N Alois Tripam Comfort Dental - Thompson Valley ADP # th St. S.W Loveland General Dentist C, E1-2, N Stuart Moss Stuart Moss & Associates ADP #4 421 W. 104th Ave., # Northglenn General Dentist *, **, C, E1-2 Scott Welch Stuart Moss & Associates ADP #4 421 W. 104th Ave., # Northglenn General Dentist *, **, C, E1-2 Michael G. Hale Dr. Michael G. Hale ADP # E. Parker Square Dr. # Parker General Dentist C, N Roger B. Elton Dr. Roger B. Elton Not Needed S. Parker Rd Parker Orthodontist None Andrey Nazarov Front Range Ortho Not Needed S. Dransfeldt Rd. # Parker Orthodontist None Anthony Knowlton Sandalwood Dental Care Center ADP # Sandalwood Lane Pueblo General Dentist *, C, E1-2, E3-4 Richard C. Moreschini Dr. Richard C. Moreschini ADP # W. 6th St Pueblo General Dentist C, E1-2, N Christopher Hasselback Comfort Dental - Pueblo - North ADP # W. US Hwy. 50, Ste. A Pueblo General Dentist *, **, C, E1-2, E3-4 Phillip Holden Comfort Dental - Pueblo - North ADP # W. US Hwy. 50, Ste. A Pueblo General Dentist *, **, C, E1-2, E3-4 Steve Carter Comfort Dental - Pueblo - North ADP # W. US Hwy. 50, Ste. A Pueblo General Dentist *, **, C, E1-2, E3-4 Bradley Michael Almond Comfort Dental - Pueblo - South ADP # S. Pueblo Blvd Pueblo General Dentist *, **, C, E1-2, E3-4 Russell Allen Poole Comfort Dental - Pueblo - South ADP # S. Pueblo Blvd Pueblo General Dentist *, **, C, E1-2, E3-4 Gino Ortegon Dr. Gino Ortegon ADP # W.12th St Pueblo General Dentist **, C, E1-2, N Gary Graves Dr. Gary Graves ADP # W. Highway 50, # Pueblo General Dentist *, **, C, E1-2 Howard Stringert Dr. Howard Stringert Not Needed 3955 Sandelwood Lane Pueblo Orthodontist None Gary Weber Dr. Gary Weber ADP # S. 3rd Ave Sterling General Dentist *, C, E1-2, E3-4 Greg Schlagel AAA Family Dental Center ADP # Eppinger Blvd Thornton General Dentist *, C, E1-2, E3-4, N Damon C. WIlkerson Colo Orthodontics Not Needed 3984 E. 120th Ave Thornton Orthodontist None John Bailey Colo Orthodontics Not Needed 3984 E. 120th Ave Thornton Orthodontist None James H. Mason Colo Orthodontics Not Needed 3984 E. 120th Ave Thornton Orthodontist None Greg Stoll Dr. Greg Stoll Not Needed 3861 E. 120th Ave Thornton Orthodontist None Michael D. Bellon Family Dental Care VII Not Needed 2200 E. 104th Ave Thornton Orthodontist None Jack Moss Dental Health Center ADP # Sheridan Blvd., 3rd Fl Westminster General Dentist *, C, E1-2, E3-4 Steven Perry Dental Health Center ADP # Sheridan Blvd., 3rd Fl Westminster General Dentist *, C, E1-2, E3-4 Page 6 of 7

19 Alpha Dental Plan Complete Provider Directory 10/20/2006 NAME OFFICE NAME PROVIDER ADDRESS PHONE CITY SPECIALTY CODES Allen Skromme Dental Health Center ADP # Sheridan Blvd., 3rd Fl Westminster General Dentist *, C, E1-2, E3-4 Damon C. WIlkerson Colo Orthodontics Not Needed 2701 W. 84th Ave Westminster Orthodontist None James H. Mason Colo Orthodontics Not Needed 2701 W. 84th Ave Westminster Orthodontist None Hilary Neilberg-Baskin Comfort Smile Center Not Needed 8113 W. 94th Ave Westminster Orthodontist None Jonathan Weinbach Smile Zone Orthodontics Not Needed 8120 Sheridan, #C Westminster Orthodontist None Thomes Jorgensen Sante Fe Dental ADP # W. 38th Ave Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Thomas Herrera Sante Fe Dental ADP # W. 38th Ave Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Kevin Marshall Comfort Dental - Wheat Ridge ADP # W. 26th Av.e # Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Christopher Hasselback Comfort Dental - Wheat Ridge ADP # W. 26th Av.e # Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Lewis Sherman Comfort Dental - Wheat Ridge ADP # W. 26th Av.e # Wheat Ridge General Dentist *, **, C, E1-2, E3-4 Bottom page General Provisions: Code Definitions: All specialty care (except for Orthodontics) has been contracted at a 20% discount. You must select a General Dentist for primary care. You may see any of the Specialists as the need arises. Call the plan office for a list of participating specialists. * - These offices have nitrous oxide. C - Accepts most children age 4 and up for routine care. Other offices may accept older children, please check with your dental office. Orthodontic co-pays are listed in your schedule of benefits. E1-2 - These offices have indicated they will provide 1 and 2 canal Endodontic Services (root canal) in certain situations. Each family member must see the same dentist. You may change your selected dentist at any time by calling the Dental Plan administrative office. E3-4 - These offices have indicated they will provide 3 and 4 canal Endodontic Services (root canal) in certain situations. N These offices will accept new patients the 1 st of the month only, not mid-month. ** Estos consultorios tienen personal de habla hispana. Page 7 of 7

20 ATTENTION EMPLOYEES! DENTAL PLAN OPEN ENROLLMENT ENDS SOON! We are proud to make available to all of our employees a new dental plan. The features of this plan are as follows: Save a minimum of 65% on all of your dental expenses No waiting periods on any benefits (even crowns and Ortho) No Claim Forms to Complete or age limits Unlimited benefits each year Orthodontics (child & adult) No Pre-authorizations Cosmetic Dentistry included Very low monthly rates to participate! PLEASE NOTE! EMPLOYEES MUST EITHER ENROLL OR COMPLETE THE WAIVER FORM. EMPLOYEES WAIVING WILL NOT BE ABLE TO ENROLL AGAIN UNTIL THE NEXT ENROLLMENT PERIOD (ONE YEAR FROM NOW) ASK YOUR SUPERVISOR OR HUMAN RESOURCES TODAY FOR YOUR ENROLLMENT PACKET OR WHEN THE ENROLLMENT MEETING(S) WILL BE