What s New for Employer Sponsored Plans for Premier

							What’s New for Employer-Sponsored Plans for 2009
(Premier and PPO Plans Standard, Plan A, and Plan B with and without orthodontia - 204, 205, 206, 207,
212, 213, 404, 405, 406, 407, 412, and 413)

To GoSM Annual Maximum Carryover
The Delta Dental Premier and PPO plans allow enrollees to carryover unused annual maximums
from one year to the next – offering them more flexibility and helping them plan for more
extensive and costly dental treatment in subsequent years by increasing their annual maximum
dollars.
         To Go Example*
         Year 1
         Annual Maximum: .............................................................$1,500
         Eligible Benefits Used: ..........................................................$500
         Unused Annual Maximum: ................................................$1,000
         To Go Annual Maximum Carryover: .................................$1,000

          Year 2
          Annual Maximum: .............................................................$1,500
          To Go Annual Maximum Carryover from Year 1: .............$1,000
          Total Annual Maximum for Year 2: ...................................$2,500
          * Please see your benefits certificate for complete details on To Go and eligibility for unused annual
          maximums.

Q: In 2008, I used $500 of my $1,500 annual maximum, will my annual maximum for 2009
be $2,500 now that To Go is included?
A: No, the To Go – Annual Maximum Carryover is a new benefit for 2009. Annual maximums
not used in 2009 will be carried over to 2010. For example, if you use $1,200 of your $1,500
annual maximum in 2009, you would have $300 to carryover in 2010 for a total annual maximum
of $1,800 in 2010.

Q: Are there any special criteria that needs to be met for unused annual maximums to
carryover to the next year?
A: Yes, you must have been enrolled on the group’s plan for a full calendar year and have had a
dental service that applies to the annual maximum during the year. For example, if you are a new
enrollee in July 2009, you will need to be enrolled the remainder of 2009 and all of calendar year
2010 to be eligible for the To Go Annual Maximum Carryover in January 2011.

Q: Is there a maximum amount of dollars that can carryover into my To Go – Annual
Maximum Carryover Bank?
A: Yes, assuming you fulfill the criteria listed above, your To Go Bank cannot exceed your total
annual maximum. For example if your annual maximum is $1,500, your To Go Bank cannot
exceed $1,500. Your total available annual maximum dollars would not exceed $3,000.
Q: Can I share my To Go – Annual Maximum Carryover dollars with my spouse or child?
A: No, the To Go – Annual Maximum Carryover benefit is based on each individual covered on
your contract. However, if yours spouse or child is covered on your contract each of them can
carryover their own unused benefits to the following year.



2401 S.E. Tones Drive, Suite 13                    Toll Free 877-983-3582
Ankeny, IA 50021                                   Facsimile 515-261-5573             WE LOVE TO SEE your SMILE®
Enhanced Benefits Program – Extra Cleaning for Diabetes and Pregnancy
The Enhanced Benefits Program offers additional preventive screenings and cleanings for
pregnant women and persons with diabetes. Studies show that treatment of gum disease can
reduce the incidence of low birth weight, preterm babies and the severity of diabetes.

Q: I qualify for the Enhanced Benefits Program, what do I need to do to get the extra
cleanings?
A: You can do one of the following:
1. Go to the Subscriber Connection at www.deltadentalia.com and select EBD Health History.
   (Login and password are required)
2. Ask your dentist to notify Delta Dental of Iowa of your benefit.
3. Call Delta Dental’s Customer Service at 1-800-544-0718, Mon-Fri 7:30 am - 5:00 pm.

Q: How many extra cleanings am I eligible for under the Enhanced Benefits Program?
A: Persons with diabetes will be eligible for four visits per year and pregnant women are eligible
for one additional visit during the time of the pregnancy.

Q: Why is Delta Dental offering this benefit to only diabetics and pregnant women?
A: This enhancement is part of the growing understanding of the connection between oral health
and overall health. As more research is done additional conditions may be added to this benefit.


Increased Orthodontia Benefit
Employers can choose to add orthodontia benefits to their group plan. Delta Dental’s lifetime
benefit for orthodontia has increased to $1,500 per child. Employers currently offering
orthodontia benefits will have the benefit increased to $1,500 per child.

Q: What if my child is currently receiving orthodontia treatment, when will this increase be
effective?
A: The increase in the benefit will be effective at the group’s renewal date.

Q: My child has already used the $1,000 lifetime benefit and is still receiving orthodontia
treatment, will my child be eligible for the increased benefit?
A: Yes, your child will be eligible for the additional $500 at your employer’s group renewal date.
If your child is still in active treatment and within the original treatment schedule, Delta Dental
will resume payments effective at your employer’s group renewal date until the end of the
orthodontia treatment schedule or lifetime maximum is met. No retroactive payments will be
made.

Q: Does Delta Dental need to be notified if I want the additional benefit for my child.
A: No, at your employer’s group renewal date, Delta Dental will automatically increase the
orthodontia benefit.

Q: Does my dependent over age 19 qualify for orthodontia benefits.
A; No. the orthodontia is a benefit for dependents up to age 19 only.


2401 S.E. Tones Drive, Suite 13           Toll Free 877-983-3582
Ankeny, IA 50021                          Facsimile 515-261-5573      WE LOVE TO SEE your SMILE®