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					-RUGDQ 6FKRRO 'LVWULFW
                                                                       6800$5< 2) %(1(),76
                                                                                     


                                                               SILVER DISCOUNT PLAN
                                                       In-Network Benefits Only - 920 Dentists
Preventive
  Routine exams, cleanings (2 per year),                               Up to 90%
  topical fluoride, x-rays                                           Fee Reduction
Basic
  Fillings, extractions, and oral surgery                              Up to 60%
                                                                     Fee Reduction

Major
  Crowns, bridges, dentures and endodontics                            Up to 50%
  and periodontics                                                   Fee Reduction
Orthodontics
                               Children and Adults:                   20% Discount
                                      Lifetime Max:                   No Maximum

Maximum Benefit (Per Year)
  Preventive, Basic and Major services per                            No Maximum
  person per year.

Deductible        (Per Year)

                                        Per Person:                        $0
                                       Family Max:

Specialists
  Endodontists, Oral Surgeons, Pediatric
  Specialists, Periodontists, Prosthodontists.                          'LVFRXQW




                                                 4/13/2011 3:33 PM
-RUGDQ 6FKRRO 'LVWULFW
                                                                               6800$5< 2) %(1(),76
                                                                                             
                                                                          Co-Pay High Plan
                                                                  Gold Network - 1296 Dentists
                                                           Network Dentist          Non-Network Dentist
Preventive
  Routine exams, cleanings (2 per year),
  topical fluoride, x-rays                                      100%


Basic
  Fillings, periodontics and oral surgery                                            See Out of Network
                                                                                          Payment
                                                            Fixed Co-pays
Major                                                   Refer to Patient Co-pay
  Crowns, bridges, dentures and endodontics




Orthodontics
                               Children and Adults:          20% Discount               No Coverage
                                     Lifetime Max:           No Maximum


Maximum Benefit (Per Year)
  Preventive, Basic and Major services per
                                                             No Maximum                 No Maximum
  person per year.

Deductible        (Per Year)
  Per Person/3x Per Family                                  No Deductible              No Deductible
  Applies to Basic and Major Services


Specialists
  Endodontists, Oral Surgeons, Pediatric
  Specialists, Periodontists, Prosthodontists.
                                                               'LVFRXQW               No Coverage




                                                      4/13/2011 3:33 PM
-RUGDQ 6FKRRO 'LVWULFW
80% R&C                                                                               6800$5< 2) %(1(),76
                                                                                                    
                                                                  INDEMNITY PLAN
                                                           Platinum Network - 1802 Dentists
                                                       * Network Dentist                 ** Non-Network Dentist
Preventive
 Routine exams, cleanings (2 per year),
 topical fluoride, x-rays
                                                             80%                                   80% of R&C


Basic
 Fillings, extractions, oral surgery                         80%                                   60% of R&C


                                                                         3 Month Waiting Period

Major
 Crowns, bridges, dentures, endodontics and                  50%                                   40% of R&C
 periodontics


                                                                         12 Month Waiting Period
Orthodontics                                                 50%                                      50%
 Children under 19                                                       12 Month Waiting Period
                              Lifetime Maximum:                                $1,000.00

                                                          20% Discount                              No Discount
 All Members

Maximum Benefit
 Per Year                                                                    $1,000.00
 Preventive, Basic and Major services per
 person per year.

Deductible
 Per Year
 Applies to Basic and Major Services
                                       Per Person:         $50.00                                   $50.00
                                Family Maximum:            $150.00                                  $150.00
Specialists
 Endodontists, Oral Surgeons, Pediatric
 Specialists, Periodontists, Prosthodontists.               6HH 1RWHV                     Paid Same as General Dentists




                                                     4/13/2011 3:33 PM
-RUGDQ 6FKRRO 'LVWULFW                                                                                                                    'HQWDO 3ODQ 1RWHV
                                                                                                                                                      
Network Access
        Texas
        Four networks are utilized in Texas, the Dental Select Signature, Platinum and Gold Networks, and the Connection Dental Network. Access to
        Connection Dental Network is only allowed if enrolled on a co-insurance plan using the Dental Select Signature or Platinum Networks. Co-pay
        plans affliated with either the Gold or Platinum networks, and co-insurance plans using the Gold Network utilize the Dental Select Networks only.

        Dental Select participating general dentists accept the Platinum, Signature, or Gold fee schedule as payment in full. Connection Dental participating
        general dentists accept the Connection Dental Fee Schedule as payment in full.
        Contracted Specialists - Texas
        Connection Dental Network: Services rendered by Connection Dental Participating Specialist will be reimbursed according to the Connection Dental
        fee schedule as payment in full. Orthodontics: The maximum charge allowed is $3,800
        Dental Select Platinum or Signature Networks: Services rendered by a Dental Select Participating Specialist will be reimbursed as follows.
                   1) You receive a 20% discount off the Specialist's fee.
                   2) Plan pays according to the General Dentists Schedule of Fees.
                   3) Member is responsible for the difference between the Plan's payment & the discounted Specialist's fee.

        Nevada Members – Diversified Dental Services
        Contracted General Dentists and Specialists: Benefits are paid off of the Diversified fee schedule there is no balance billing.
        Utah
        Dental Select participating general dentists accept the Signature, Platinum or Gold fee schedule as payment in full.
        Contracted Specialists - Utah
        Dental Select Signature or Platinum Networks: Services rendered by a Dental Select Participating Specialist will be reimbursed as follows.
                   1) You receive a 20% discount off the Specialist's fee.
                   2) Plan pays according to the General Dentists Schedule of Fees.
                   3) Member is responsible for the difference between the Plan's payment & the discounted Specialist's fee.

        Co-Pay Plans - See Schedule of co-payments for patient responsibility
        Other States – Connection Dental
        Contracted General Dentists and Specialists: Benefits are paid off of the Connection Dental fee schedule; there is no balance billing.
        Orthodontics: The maximum charge allowed is $3,800
Plan Notes
        Silver
        Discount only; no benefit will be paid.

        Co-Pay Plans
        COVERAGE: CO-PAYS: The patient's co-payments in the Schedule of Covered Services are subject to change on January 1, of each year.
        Specialist Discount: Discount only; no benefit will be paid. IN NETWORK: General Dentists: Accept a combination of fixed co-pay and insurance
        payment as payment in full. OUT OF NETWORK: The member will be responsible for paying the difference between what the dentist charges and
        the plan payment.

        Indemnity
        IN NETWORK: General Dentists & Specialists: All payments made by the plan are based on the Platinum or Connection Dental Fee Schedule.
        OUT OF NETWORK: Dental Select will allow up to the reasonable and customary charge for the dental procedures and services after the required
        deductible amount, as shown. Charges above the plan payment are the patient's responsibility. DISCOUNT: Discount only; no benefit will be paid.




                                                                   4/13/2011 3:33 PM
                                                                                                                               Discount – Silver
                                                                          Toll Free: 800-999-9789               Toll Free Fax: 888-673-5328             DentalSelect.com



                                                                     Easy to Use Discount Dental Plan
                                                                           ฀ Affordable rates
                                                                           ฀ No deductibles
                                                                           ฀ No waiting periods
                                                                           ฀ No age limits
                                                                           ฀ No annual maximums
                                                                           ฀ Dental discounts available the day you enroll
                                                                           ฀ Plan includes all existing dental health concerns
                                                                             (excluding treatments in progress)
                                                                           ฀ Includes adult and child orthodontics
                                                                           ฀ Includes teeth bleaching and other cosmetic procedures
                                                                           ฀ Parents and Grandparents may be included on this plan




                                                                                                                      Silver
                                                                                                 Plan Type: Fee-For-Service Discount
How It Works
                                                                                                                                        Contracted Discount
 Our large panel of Silver contracted providers offer a discounted
 rate for Dental Select Discount Plan members.                       Preventive                                                            Up to 80% Fee Reduction
                                                                     Cleanings, exams, fluoride and x-rays


 The Discount Plan allows employees and their families to save       Basic                                                                 Up to 60% Fee Reduction
                                                                     Fillings and oral surgery
 up to 70% on most dental services the day they enroll.
                                                                     Major
                                                                     Crowns, bridges, Periodontics, Endodontics and                        Up to 50% Fee Reduction
                                                                     dentures

                                                                     Specialists
                                                                     Orthodontist, Oral Surgeon, Prosthodontist, Endo-                           20% Discount
                                                                     dontist, Periodontist and Pediatric Specialist

                                                                     Orthodontics
                                                                                                           Children & Adults                     20% Discount
                                                                                                 Lifetime Maximum (Benefit)                          None

                                                                     Deductible                                                                        $0

                                                                     Maximum Benefit                                                              No Maximum
How to Find a Provider                                               Waiting Periods
                                                                                                                      Basic
 Visit www.dentalselect.com and click on the                                                                         Major
                                                                                                                                                     None

 link at the top right of your browser.                                                                         Orthodontic


                                                                        The Discount Plan is not a dental insurance policy. This program provides discounts only from a specific
                                                                     network of dental providers. The member is responsible to pay for all services but will receive a discount from
                                                                                         dental providers who are contracted on Dental Select’s Silver Network.




                                                                                                                                                                          EB09001
                                                                                                    Discount Schedule – Silver
                                                                              Toll Free: 800-999-9789              Toll Free Fax: 888-673-5328            DentalSelect.com



              Schedule of Member Fees For Network General Dentists
                                                                       Utah

Code          Procedure Description                                                                               Patient Fee
PREVENTIVE
D120           Routine checkup                                                                                        17
D150           Comprehensive oral exam                                                                                15
D210           X-rays, complete set                                                                                   35
D220           X-rays, periapical, 1st film                                                                            8
D272           X-rays, bitewing, 2 films                                                                               12
D274           X-rays, bitewing, 4 films                                                                               16
D330           X-rays, panoramic film                                                                                  37
D1110          Cleaning - adult                                                                                       37

BASIC
D140           Limited oral examination                                                                               10
D1351          Sealant - per tooth (age 14 and under)                                                                 19

Amalgam (Silver) Fillings
D2140         Amalgam - 1 surface                                                                                     41
D2150         Amalgam - 2 surface                                                                                     51
D2160         Amalgam - 3 surface                                                                                     62
D2161         Amalgam - 4+ surfaces                                                                                   71

Anterior Composite (White) Fillings
D2330         Composite- 1 surface anterior                                                                           63
D2331         Composite - 2 surface anterior                                                                          74
D2332         Composite - 3 surface anterior                                                                          84
D2335         Composite - 4+ surfaces anterior                                                                        99

Posterior Composite (White) Fillings
D2391         Composite - 1 surface posterior                                                                         63
D2392         Composite - 2 surface posterior                                                                         84
D2393         Composite - 3 surface posterior                                                                        102
D2394         Composite - 4+ surfaces posterior                                                                      108

CROWNS
D2750          Crown - porcelain, high noble metal                                                                   460
D2751          Crown - porcelain, predominantly base metal                                                           437
D2752          Crown – porcelain, noble metal                                                                        442

ENDODONTICS (ROOT CANALS)
D3310        Pulp cap - direct, excluding final restoration                                                           246
D3320        Root canal - bicuspid, excluding final restoration                                                       308
D3330        Root canal - molar, excluding final restoration                                                          395

PERIODONTICS
D4341        Periodontal root planing, 4+ per quad                                                              20% Discount
D4910        Periodontal maintenance procedure                                                                      71

PROSTHODONTICS (DENTURES)
D5110       Complete denture - upper                                                                                 510
D5120       Complete denture - lower                                                                                 510

ORAL SURGERY
D7210        Surgical extraction                                                                                    83
D7220        Surgical extraction, impacted                                                                          102
D7230        Surgical extraction, partial bony                                                                  20% Discount
D7240        Surgical extraction, completely bony                                                               20% Discount

MISCELLANEOUS
D1450       OSHA infection and sterilization                                                                          10
D9440       Office visit for observation - after hours                                                                 36

This is not a complete list of procedures. You will receive the complete version with your plan ID card. Any procedure not listed is available on a fee
                               for service basis, no discount will apply. This sample of fees is effective January 1, 2011.




                                                                                                                                                                  Utah
                                                                                                                                                                UTEB09001CP
                                                                                                                                                              Co-Pay – Gold
                                                                                               Toll Free: 800-999-9789                 Toll Free Fax: 888-673-5328         DentalSelect.com



                                                                                           Simple Co-Pay Dental Plan
                                                                                                ฀ No waiting periods
                                                                                                ฀ No annual maximums
                                                                                                ฀ Large panel of Gold Providers
                                                                                                ฀ Fixed affordable co-payments
                                                                                                ฀ Includes non-contracted provider benefit

                                                                                           Enjoy these great features from any contracted provider
                                                                                                ฀ Covers preventive care at 100%
                                                                                                ฀ Includes implant crown discount
                                                                                                ฀ Includes discount on teeth bleaching and veneers

                                                                                           All Specialist Types Available
How It Works                                                                                    ฀ Specialists include:
 Co-Pay Plans are insured dental plans designed to offer the                                          ฀                ฀                  ฀฀฀฀฀ ฀      ฀
 best overall value with affordable premiums and lower out-of-                                        ฀                         ฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀ ฀
 pocket costs.                                                                                        ฀                            ฀฀฀฀฀฀฀฀฀฀฀฀ ฀

    ฀    ฀       ฀ ฀    ฀          ฀       ฀ ฀        ฀                              ฀ ฀
 payment in full for Dental Select Gold Plan members.

 Use your Co-Pay plan without the restriction of waiting periods                                                                    Gold Network
 and also receive 100% coverage for preventive services when                                                                       Plan Type: Co-Pay Plan
 using a contracted provider. Discounts also available for                                                                                 Contracted                    Non-Contracted
 bleaching, cosmetic and orthodontic services.
                                                                                           Preventive
                                                                                           Cleanings (2 per Year), exams,                       100%
                                                                                           fluoride and x-rays

                                                                                           Basic
Access Dental Select’s Web Portal                                                                 ฀            ฀   ฀        ฀                                         See Sample Payment Schedule
                                                                                           Surgery                                          Fixed Co-Pays
   ฀ View your Claim Status                                                                Major
                                                                                                                                    (See Sample Payment Schedule)
                                                                                           Crowns, bridges, Endodontics
   ฀ View your Explanation of Benefits                                                      and dentures

   ฀ Print a temporary ID Card                                                             Specialists
                                                                                                        ฀    ฀        ฀                      20% Discount
   ฀         ฀ ฀                                                                           Prosthodontist, Endodontist,                       ฀    ฀฀ ฀       ฀   ฀
                                                                                           Periodontist and Pediatric                           be paid)
   ฀ Register at www.dentalselect.com                                                      Specialist                                                                         No Benefit

                                                                                           Orthodontics                                      20% Discount
                                                                                           Children & Adults                                  ฀    ฀฀ ฀       ฀   ฀
                                                                                                                                                be paid)

                                                                                           Deductible                                                       No Deductible
How to Find a Provider
                                                                                           Maximum Benefit                                                     No Maximum
 Visit www.dentalselect.com and click on the
                                                                                           Waiting Periods
 link at the top right of your browser.                                                                                    Basic                                  None
                                                                                                                           Major




       ACE USA is the U.S. domestic operating division of ACE Limited. Insurance                  The benefits illustrated are in summary form only. They should not be construed as complete in and of
       products and services are provided by the U.S. insurance underwriting                      themselves. They are only for comparison and in the case of discrepancy, the plan documents apply.
       companies and not by ACE Limited. This plan of insurance is underwritten by
                                                                                                  Please refer to the plan certificate booklet for a complete description of benefits, limitations and
       ACE American Insurance Company.
                                                                                                  exclusions.

                                                                                                                                                                                           EB09002
                                                                                                                      Co-Pay Schedule – UT-1 Gold
                                                                                                        Toll Free: 800-999-9789               Toll Free Fax: 888-673-5328               DentalSelect.com



                                               Network General Dentists – Sample Payment Schedule
             Please contact a Customer Service Representative at 800-999-9789 to confirm your co-payment if you visit a provider in any county not listed.

                                                                                                                                               UT-1 Gold
                                                                                                                               Salt Lake, Davis, Weber, Utah and Tooele Counties only

                                                                                                         Patient Co-Pay                        Plan Payment In &                        Pediatric Co-Pay
Code          Procedure Description                                                                        In-network                           Out-of-network*                           In-network
PREVENTIVE
D120           Routine checkup                                                                                  0                                       17                                     0
D150           Comprehensive oral exam                                                                          0                                       19                                     0
D210           X-rays, complete set                                                                             0                                       37                                     0
D220           X-rays, periapical, 1st film                                                                      0                                       8                                      0
D272           X-rays, bitewing, 2 films                                                                         0                                       14                                     0
D274           X-rays, bitewing, 4 films                                                                         0                                       17                                     0
D330           X-rays, panoramic film                                                                            0                                       37                                     0
D1110          Cleaning - adult                                                                                 0                                       37                                     0

BASIC
D140           Limited oral examination                                                                        0                                        12                              20% Discount*
D1351          Sealant - per tooth (age 14 and under)                                                          12                                       8                               20% Discount*

Amalgam (Silver) Fillings
D2140         Amalgam - 1 surface                                                                              11                                       32                              20% Discount*
D2150         Amalgam - 2 surface                                                                              19                                       34                              20% Discount*
D2160         Amalgam - 3 surface                                                                              26                                       38                              20% Discount*
D2161         Amalgam - 4+ surfaces                                                                            34                                       39                              20% Discount*

Anterior Composite (White) Fillings
D2330         Composite- 1 surface anterior                                                                    33                                       32                              20% Discount*
D2331         Composite - 2 surface anterior                                                                   36                                       40                              20% Discount*
D2332         Composite - 3 surface anterior                                                                   42                                       44                              20% Discount*
D2335         Composite - 4+ surfaces anterior                                                                 50                                       51                              20% Discount*

Posterior Composite (White) Fillings
D2391         Composite - 1 surface posterior                                                                  32                                       32                              20% Discount*
D2392         Composite - 2 surface posterior                                                                  48                                       39                              20% Discount*
D2393         Composite - 3 surface posterior                                                                  60                                       45                              20% Discount*
D2394         Composite - 4+ surfaces posterior                                                                66                                       48                              20% Discount*

CROWNS
D2750          Crown - porcelain, high noble metal                                                             287                                     185                              20% Discount*
D2751          Crown - porcelain, predominantly base metal                                                     290                                     151                              20% Discount*
D2752          Crown – porcelain, noble metal                                                                  293                                     153                              20% Discount*

ENDODONTICS (ROOT CANALS)
D3310        Pulp cap - direct, excluding final restoration                                                     165                                      82                              20% Discount*
D3320        Root canal - bicuspid, excluding final restoration                                                 220                                      90                              20% Discount*
D3330        Root canal - molar, excluding final restoration                                                    303                                      92                              20% Discount*

PERIODONTICS
D4341        Periodontal root planing, 4+ per quad                                                             79                                       19                              20% Discount*
D4910        Periodontal maintenance procedure                                                                 55                                       17                              20% Discount*

PROSTHODONTICS (DENTURES)
D5110       Complete denture - upper                                                                           401                                     111                              20% Discount*
D5120       Complete denture - lower                                                                           401                                     111                              20% Discount*

ORAL SURGERY
D7210        Surgical extraction                                                                               59                                       26                              20% Discount*
D7220        Surgical extraction, impacted                                                                     78                                       28                              20% Discount*
D7230        Surgical extraction, partial bony                                                                 98                                       34                              20% Discount*
D7240        Surgical extraction, completely bony                                                              115                                      34                              20% Discount*

MISCELLANEOUS
D1450       OSHA infection and sterilization                                                                   10                                        0                                   10
D9440       Office visit for observation - after hours                                                          37                                        0                              20% Discount*

                      * For services rendered by out-of-network providers the patient is responsible for the difference between the plan payment and the provider’s standard fee.
                No balance billing for services rendered by an in-network provider. This is not a complete list of procedures. You will receive the complete version with your plan ID card.
                                  Any procedure not listed is available on a fee for service basis, no discount will apply. This sample of fees is effective January 1, 2011.




                                                                                                                                                                                                      Utah
                                                                                                                                                                                                   UT1EB09002CP
                                                                                                                        Indemnity – Platinum
                                                                                      Toll Free: 800-999-9789       Toll Free Fax: 888-673-5328        DentalSelect.com



                                                                                   Flexible Dental Plan
                                                                                   Enjoy these great features from any contracted provider
                                                                                       ฀ Covers preventive care at 80% (in-network)
                                                                                       ฀ Lower out-of-pocket costs
                                                                                       ฀ Includes cosmetic discounts

                                                                                       ฀ Includes adult and child orthodontic discount



                                                                                   All Specialist Types Available
                                                                                       ฀ Specialists include:
                                                                                           ฀            ฀              ฀฀฀฀฀ ฀     ฀
                                                                                           ฀                 ฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀฀ ฀
                                                                                           ฀                     ฀฀฀฀฀฀฀฀฀฀฀฀ ฀

                                                                                    Contracted Specialists: The plan will pay based on our General Dentist contracted
                                                                                    fee schedule. The member will also receive a 20% discount off of the contracted
                                                                                    Specialist’s fee. The Member is responsible for the difference between the plan’s
How It Works                                                                        payment and the Specialist’s fee.

 Indemnity Plans are insured dental plans designed to offer                         Non-Contracted Specialists: No discount. Plan will pay based on Reasonable &
                                                                                    Customary fees. The Member is responsible for the difference between the plan’s
 the greatest choice. You can choose any dentist at any time                        payment and the Specialist’s fee.
 but the out-of-pocket savings advantage is best when visiting
 a contracted Platinum provider.

 Our large panel of Platinum providers accepts a contracted                        Access Dental Select’s Web Portal
 rate as payment in full for Dental Select Platinum Plan
 members.                                                                              ฀ View your Claim Status
                                                                                       ฀ View your Explanation of Benefits
 Use your PPO Plan and receive 80% (in-network) coverage
 for preventive services when using a contracted provider.                             ฀ Print a temporary ID Card
 Discounts are also available for bleaching, cosmetic and
                                                                                       ฀ Order ID Cards
 orthodontic services.
                                                                                       ฀ Register at www.dentalselect.com
How to Find a Provider
 Visit www.dentalselect.com and click on the
 link at the top right of your browser.




     ACE USA is the U.S. domestic operating division of ACE Limited. Insurance
     products and services are provided by the U.S. insurance underwriting
     companies and not by ACE Limited. This plan of insurance is underwritten by
     ACE American Insurance Company.

                                                                                                                                                                  EB09031JSD
                                                                                                                       Find A Provider
                                                                             Toll Free: 800-999-9789   Toll Free Fax: 888-998-8704   DentalSelect.com



Locate a Dental Select Provider – Two easy ways

1. Search for a provider on our Website.
Go to www.dentalselect.com to find a
provider and select the “Find a Provider”
button at the top of the home page. Enter
your desired search options and select the
“Search” button at the bottom of the page.
A list of providers that match your search
criteria will be displayed. You can print the
list of providers by selecting the “Print All”
button.


2. Request a printed provider directory

Call Dental Select Member Services at 801-495-3000 or toll free at 1-800-999-9789 to request a printed
provider directory.



Contracted Provider Verification
When calling to verify if a provider accepts Dental Select insurance, be sure to ask if they are a “Contracted
Dental Select Provider”.
Most dental providers will file an insurance claim to Dental Select, but only contracted providers accept our fee schedule as payment in full.
Providers that are not contracted with Dental Select will balance bill the member.




                                                                                                                                          UT2011 FAP 01/11
                                                                                                                      Find A Provider
                                                                            Toll Free: 800-999-9789   Toll Free Fax: 888-998-8704   DentalSelect.com




Como localizar un Proveedor (Dentistas) de Dental Select Dos

1. Buscar Dentistas en nuestra pagina del
Internet.

Para encontrar un dentista por el Inter-
net escriba la siguiente dirección www.
dentalselect.com y seleccione la opción
“Dental Providers” que es la primera opción
en la página. Entre su selección y escoja
“Search” en la parte de abajo de la pagina.
La lista de proveedores de acuerdo a su
selección se desplazara. Si Usted desea im-
primir la pagina solo seleccione “Print All.”

2. Para obtener un Directorio de Proveedores

Comuníquese con el Servicio para Miembros de Dental Select al siguiente numero 801-495-3000 o al nu-
mero gratis 1-800-999-9789.



Verificación de Proveedores Contratados
Cuando llame para verificar, si el Dentista acepta su Plan, asegúrese de preguntar si ellos están “Contrata-
dos con Dental Select.”
La majoriá de los proveedores van ha enviar un reclamo a Dental Select, pero solo los proveedores contratados aceptaran nuestros precios a la
totalidad. Dentistas que no están contratados con Dental Select, le enviaran una factura con el balance al dueño de la póliza.




                                                                                                                                        UT2011 FAP 01/11
                                                                                                              Provider Referral Form
                                                                                             Phone: 801-495-3000   Toll Free: 800-999-9789   DentalSelect.com

Please consider my dentist for potential membership in the Dental Select network. I understand your dental network has the authority to make the final decision
about membership approvals. I also understand my name may be mentioned as the person who referred the dentist to you.

Patient Information
Date:                                                                            Plan:


Patient Name:


Employer:


Phone number:                                                                    Email:




Dentist Information
Name:


Address:


City:


State:                                                                           Zip Code:


Phone Number:


Specialty:




* Call your dentist to verify status of participation.


                               Please visit www.dentalselect.com or complete this form and submit to:

                                                                     Corporate Office
                                                  5373 S. Green Street, 4th Floor, Salt Lake City, UT 84123
                                                        (801) 495-3000 - Toll Free 1-800-999-9789
                                                    Fax (801) 495-3368 - Toll Free Fax 1-888-673-5328




                                                                                                                                                    2010 PRF 08/10
                              TM




2011 Jordan School District




emihealth.com
                                              Please Note

This listing of participating dental providers is subject to change at any time without notice. Insureds
should present their EMI Health ID cards and confirm their providers' panel status at the time
of each visit.

EMI Health dental providers offer you high quality care statewide. Participating dental providers have
contracted with EMI Heatlh to accept our table of allowances which reduces your out-of-pocket
expenses for most dental services.

When selecting a dental provider, please remember the following information:

       •   Participating dental providers agree to accept EMI Health's payment schedule, along
           with your co-payment, as payment in full.

       •   Participating dental providers bill EMI Health directly and do not require you to fill
           out claim forms.

       •   If you use dental providers who do not participate on the EMI Health panel, with plans
           that allow out of network benefits, you will be responsible for any charges in excess
           of the table of allowance.

       •   Make sure that the provider you select participates on your plan (Premier, Advantage,
           or Value). Your plan name is listed on your ID card and on your Summary of Benefits.

       •   Dental providers marked (*) are accepting established patients only.




                   For the most up-to-date participating provider information,
                        call EMI Health's customer service department at
                      (801) 262-7475 or toll free at (800) 662-5851, or visit
                               our website at www.emihealth.com
                                                                Jordan School District                                                                   852 East Arrowhead Lane
                                                                9361 South 300 East                                                                      Murray, Utah 84107-5298
                                                                Sandy, UT 84070                                                                     (801)262-7475 / (800)662-5851
                                                                801-567-8285                                                                                   Fax (801)269-9734
                                                                                                                                                              www.emihealth.com

Group:                                                          Jordan School District - Option 1 - (Plan #306)
Plan:                                                           Premier Access PPO
Underwritten & Administered by:                                 Educators Health Care / Educators Mutual Insurance Association
Plan Type:                                                      Voluntary / Fully Insured
Effective Date:                                                 9/1/2011
Benefit Year:                                                   Contract
                                                                                    In-Network                                                 Out-of-Network
Type 1 - Preventive                                                                      100%                                     See Claim Payment Schedule
  Oral Exams, Cleanings, X-rays, Fluoride
Type 2 - Basic                                                             See Co-Pay Schedule                                    See Claim Payment Schedule
  Fillings, Oral Surgery
Type 3 - Major                                                             See Co-Pay Schedule                                    See Claim Payment Schedule
  Crowns, Bridges, Prosthodontics
Type 4 - Orthodontics                                                              No Coverage                                                   No Coverage
  Dependent children up to age (19)
  Adults                                                                             No Coverage                                                   No Coverage
  Orthodontic Discount (All Members)                                                 25% Discount                                          y       No Coverage
Endodontics                                                            Type 3 - See Co-Pay Schedule                                   See Claim Payment Schedule
Periodontics                                                           Type 3 - See Co-Pay Schedule                                   See Claim Payment Schedule
Sealants                                                               Type 2 - See Co-Pay Schedule                                   See Claim Payment Schedule
Space Maintainers                                                      Type 2 - See Co-Pay Schedule                                   See Claim Payment Schedule
Specialists                                                              Paid same as General Dentists                                 Paid same as General Dentists
Waiting periods
 Type 2 - Basic                                                                                                          None
 Type 3 - Major                                                                                                          None
 Type 4 - Orthodontics                                                                                                   N/A
Deductible
 Per Person                                                                               $0.00                                                         $0.00
 Family Max                                                                               $0.00                                                         $0.00
Deductible Applies To                                                                     N/A                                                           N/A
Annual Maximum Per Person                                                                                             $1,500.00
Orthodontic Lifetime Maximum                                                                                            N/A
Network / Reimbursement Schedule                                                        Premier                                                       Premier
Monthly Rates
 Employee                                                                                                               $23.00
 Two-Party                                                                                                              $42.00
 Family                                                                                                                 $87.10

Provisions / Limitations / Exclusions
  Exams (including Periodontal), Cleanings and Fluoride                                                                                           2 per year
  Fluoride                                                                                                                                       Up to age 16
  Sealants                                                                                                                                       Up to age 16
  Space Maintainers                                                                                                                              Up to age 16
  Bitewing X-Rays                                                                                                                           Up to 4, twice per year
  Periapical X-Rays                                                                                                                               6 per year
  Panoramic X-Ray                                                                                                                              1 every 3 years
  Impacted Teeth                                                                                                                           Covered in Type 2 - Basic
  Anesthesia- (Age 8 and over for the extraction of impacted teeth only)                                                                   Covered in Type 3 - Major
  Anesthesia - (For children age 7 and under, once per year)                                                                               Covered in Type 3 - Major
  Implants                                                                                                                                       Not Covered
  Crowns, Pontics, Abutments, Onlays and Dentures                                                                                          1 every 5 years per tooth
  Fillings on the same surface                                                                                                                1 every 18 months
Benefits illustrated are in summary only. Refer to your Dental Handbook for a complete description of benefits, limitations and exclusions. All Services are subject to EMI Health Table of
                                                                  Allowances. No Out-of-Network Claims will be paid.
                                                          Co-Pays are subject to change January 1st of each year.
                                                                                                                                                                  EHC.DTL.COPAY.CHT.C
                                                                                                                                                   852 EAST ARROWHEAD LANE
                                                                                                                                                         MURRAY, UTAH 84107
                                                                                                                               CORPORATE (801)262-7475 TOLL FREE (800)662-5851
                                                                                                                                                                              emihealth.com
                                                                         Jordan School District
                                                                      Premier Copay Plan Option 1
                                                                     2011 Sample Co-Pay Schedule
                                                                                                                                             In-Network Patient           Out-of-Network
   Code         Code Name                                                                                                                          Co-Pay                 Claim Payment
   D0120        Periodic oral evaluation                                                                                                              0                         25
   D0140        Limited oral evaluation - problem focused                                                                                             0                         35
   D0150        Comprehensive oral evaluation - new or established patient                                                                            0                         34
   D0210        Intraoral - complete series (including bitewings)                                                                                     0                         53
   D0220        Intraoral - periapical first film                                                                                                     0                         13
   D0230        Intraoral - periapical each additional film                                                                                           0                         11
   D0270        Bitewing - single film                                                                                                                0                         12
   D0272        Bitewings - two films                                                                                                                 0                         22
   D0274        Bitewings - four films                                                                                                                0                         28
   D0330        Panoramic film                                                                                                                        0                         50
   D1110        Prophylaxis - adult                                                                                                                   0                         42
   D1120        Prophylaxis - child                                                                                                                   0                         29
   D1203        Topical application of fluoride (prophylaxis not included) - child                                                                    0                         14
   D1351        Sealant - per tooth                                                                                                                  11                         10
   D2140        Amalgam - one surface, primary or permanent                                                                                          17                         43
   D2150        Amalgam - two surfaces, primary or permanent                                                                                         24                         51
   D2160        Amalgam - three surfaces, primary or permanent                                                                                       33                         57
   D2161        Amalgam - four or more surfaces, primary or permanent                                                                                44                         61
   D2330        Resin-based composite - one surface, anterior                                                                                        35                         35
   D2331        Resin-based composite - two surfaces, anterior                                                                                       43                         42
   D2332        Resin-based composite - three surfaces, anterior                                                                                     50                         50
   D2335        Resin-based composite - four or more surfaces or involving incisal angle (anterior)                                                  60                         60
   D2391        Resin-based composite - one surface, posterior                                                                                       38                         38
   D2392        Resin-based composite - two surfaces, posterior                                                                                      46                         46
   D2393        Resin-based composite - three surfaces, posterior                                                                                    58                         57
   D2394        Resin-based composite - four or more surfaces, posterior                                                                             68                         67
   D2740        Crown - porcelain/ceramic substrate                                                                                                 380                        220
   D2750        Crown - porcelain fused to high noble metal                                                                                         380                        220
   D2751        Crown - porcelain fused to predominantly base metal                                                                                 370                        150
   D2752        Crown - porcelain fused to noble metal                                                                                              370                        150
   D2920        Recement crown                                                                                                                       34                          1
   D2950        Core buildup, including any pins                                                                                                     97                         13
   D2954        Prefabricated post and core in addition to crown                                                                                    105                         15
   D3120        Pulp cap - indirect (excluding final restoration)                                                                                    22                          3
                Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental
   D3220                                                                                                                                                60                          0
                junction and application of medicament
   D3310        Anterior (excluding final restoration)                                                                                                  209                        131
   D3320        Bicuspid (excluding final restoration)                                                                                                  270                        130
   D3330        Molar (excluding final restoration)                                                                                                     360                        150

   D4341                                                                                                                                                79                         26
            Periodontal scaling and root planing, four or more contiguous teeth or bounded teeth spaces per quadrant
   D4355    Full mouth debridement to enable comprehensive periodontal evaluation and diagnosis                                                         53                         17
            Localized delivery of chemotherapeutic agents via a controlled release vehicle into diseased
   D4381                                                                                                                                            20% Disc                        0
            crevicular tissue, per tooth, by report
   D4910    Periodontal maintenance                                                                                                                     51                         24
   D6240    Pontic - porcelain fused to high noble metal                                                                                                323                        107
   D6750    Crown - porcelain fused to high noble metal                                                                                                 350                        250
   D7111    Coronal remnants - deciduous tooth                                                                                                          25                         25
   D7140    Extraction, erupted tooth or exposed root (elevation and/or forceps removal)                                                                33                         32
            Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or
   D7210                                                                                                                                                55                         55
            section of tooth
   D7230    Removal of impacted tooth - partially bony                                                                                                75                           75
   D7240    Removal of impacted tooth - completely bony                                                                                               93                           92
D7810-D7899 Unspecified TMD therapy, by report                                                                                                      20% Disc                        0
D8010-D8999 Orthodontic retention (removal of appliances, construction and placement of retainer(s))                                                25% Disc                        0
   D9110    Palliative (emergency) treatment of dental paid - minor procedure                                                                         38                            3
   D9220    Deep sedation/general anesthesia - first 30 minutes                                                                                       160                           0
   D9230    Analgesia, anxiolysis, inhalation of nitrous oxide                                                                                        20                            0
       Underwritten or Administered by: Educators Health Plans Health, Educators Health Care, Educators Health Plans Life, Accident, and Health or Educators Mutual Insurance Association
                         Benefits illustrated are in summary only. Refer to your Group Certificate booklet for a complete description of benefits, limitations and exclusions.




                                                               Co-Pays are subject to change January 1st of each year.
                                                              Jordan School District                                                                  852 East Arrowhead Lane
                                                              9361 South 300 East                                                                     Murray, Utah 84107-5298
                                                              Sandy, UT 84070                                                                    (801)262-7475 / (800)662-5851
                                                              801-567-8285                                                                                  Fax (801)269-9734
                                                                                                                                                           www.emihealth.com

Group:                                                         Jordan School District - Option 2 - (Plan #306)
Plan:                                                          Premier Access PPO
Underwritten & Administered by:                                Educators Health Care / Educators Mutual Insurance Association
Plan Type:                                                     Voluntary / Fully Insured
Effective Date:                                                9/1/2011
Benefit Year:                                                  Contract
                                                                                   In-Network                                                Out-of-Network
Type 1 - Preventive                                                       See Co-Pay Schedule                                   See Claim Payment Schedule
 Oral Exams, Cleanings, X-rays, Fluoride
Type 2 - Basic                                                            See Co-Pay Schedule                                   See Claim Payment Schedule
 Fillings, Oral Surgery
Type 3 - Major                                                            See Co-Pay Schedule                                   See Claim Payment Schedule
 Crowns, Bridges, Prosthodontics
Type 4 - Orthodontics                                                            No Coverage                                                   No Coverage
 Dependent children up to age (19)
 Adults                                                                            No Coverage                                                   No Coverage
 Orthodontic Discount (All Members)                                                25% Discount                                          y       No Coverage
Endodontics                                                           Type 3 - See Co-Pay Schedule                                  See Claim Payment Schedule
Periodontics                                                          Type 3 - See Co-Pay Schedule                                  See Claim Payment Schedule
Sealants                                                              Type 2 - See Co-Pay Schedule                                  See Claim Payment Schedule
Space Maintainers                                                     Type 2 - See Co-Pay Schedule                                  See Claim Payment Schedule
Specialists                                                            Paid same as General Dentists                              Paid the same as General Dentists
Waiting periods
 Type 2 - Basic                                                                                                        None
 Type 3 - Major                                                                                                        None
 Type 4 - Orthodontics                                                                                                 N/A
Deductible
 Per Person                                                                              $0.00                                                        $0.00
 Family Max                                                                              $0.00                                                        $0.00
Deductible Applies To                                                                    N/A                                                          N/A
Annual Maximum Per Person                                                                                           $1,500.00
Orthodontic Lifetime Maximum                                                                                          N/A
Network / Reimbursement Schedule                                                       Premier                                                      Premier
Monthly Rates
 Employee                                                                                                             $5.90
 Two-Party                                                                                                            $12.80
 Family                                                                                                               $20.40

Provisions / Limitations / Exclusions
 Exams (including Periodontal), Cleanings and Fluoride                                                                                          2 per year
 Fluoride                                                                                                                                     Up to age 16
 Sealants                                                                                                                                     Up to age 16
 Space Maintainers                                                                                                                            Up to age 16
 Bitewing X-Rays                                                                                                                         Up to 4, twice per year
 Periapical X-Rays                                                                                                                              6 per year
 Panoramic X-Ray                                                                                                                             1 every 3 years
 Impacted Teeth                                                                                                                         Covered in Type 2 - Basic
 Anesthesia- (Age 8 and over for the extraction of impacted teeth only)                                                                 Covered in Type 3 - Major
 Anesthesia - (For children age 7 and under, once per year)                                                                             Covered in Type 3 - Major
 Implants                                                                                                                                     Not Covered
 Crowns, Pontics, Abutments, Onlays and Dentures                                                                                        1 every 5 years per tooth
 Fillings on the same surface                                                                                                              1 every 18 months
Benefits illustrated are in summary only. Refer to your Dental Handbook for a complete description of benefits, limitations and exclusions. All Services are subject to EMI Health Table
                                                                of Allowances. No Out-of-Network Claims will be paid.
                                                         Co-Pays are subject to change January 1st of each year.
                                                                                                                                                               EHC.DTL.COPAY.CHT.C
                                                                                                                                                   852 EAST ARROWHEAD LANE
                                                                                                                                                         MURRAY, UTAH 84107
                                                                                                                               CORPORATE (801)262-7475 TOLL FREE (800)662-5851
                                                                                                                                                                              emihealth.com
                                                                         Jordan School District
                                                                      Premier Copay Plan Option 2
                                                                     2011 Sample Co-Pay Schedule
                                                                                                                                             In-Network Patient           Out-of-Network
   Code         Code Name                                                                                                                          Co-Pay                 Claim Payment
   D0120        Periodic oral evaluation                                                                                                             14                         11
   D0140        Limited oral evaluation - problem focused                                                                                            10                         25
   D0150        Comprehensive oral evaluation - new or established patient                                                                           15                         19
   D0210        Intraoral - complete series (including bitewings)                                                                                    25                         28
   D0220        Intraoral - periapical first film                                                                                                     4                          9
   D0230        Intraoral - periapical each additional film                                                                                           4                          7
   D0270        Bitewing - single film                                                                                                                5                          7
   D0272        Bitewings - two films                                                                                                                 7                         15
   D0274        Bitewings - four films                                                                                                               11                         17
   D0330        Panoramic film                                                                                                                       25                         25
   D1110        Prophylaxis - adult                                                                                                                  34                          8
   D1120        Prophylaxis - child                                                                                                                  20                          9
   D1203        Topical application of fluoride (prophylaxis not included) - child                                                                    0                         14
   D1351        Sealant - per tooth                                                                                                                  21                          0
   D2140        Amalgam - one surface, primary or permanent                                                                                          50                         10
   D2150        Amalgam - two surfaces, primary or permanent                                                                                         62                         13
   D2160        Amalgam - three surfaces, primary or permanent                                                                                       82                          8
   D2161        Amalgam - four or more surfaces, primary or permanent                                                                                82                         23
   D2330        Resin-based composite - one surface, anterior                                                                                        68                          2
   D2331        Resin-based composite - two surfaces, anterior                                                                                       85                          0
   D2332        Resin-based composite - three surfaces, anterior                                                                                    100                          0
   D2335        Resin-based composite - four or more surfaces or involving incisal angle (anterior)                                                 115                          5
   D2391        Resin-based composite - one surface, posterior                                                                                       75                          1
   D2392        Resin-based composite - two surfaces, posterior                                                                                      92                          0
   D2393        Resin-based composite - three surfaces, posterior                                                                                   115                          0
   D2394        Resin-based composite - four or more surfaces, posterior                                                                            120                         15
   D2740        Crown - porcelain/ceramic substrate                                                                                                 520                         80
   D2750        Crown - porcelain fused to high noble metal                                                                                         530                         70
   D2751        Crown - porcelain fused to predominantly base metal                                                                                 520                          0
   D2752        Crown - porcelain fused to noble metal                                                                                              520                          0
   D2920        Recement crown                                                                                                                       35                          0
   D2950        Core buildup, including any pins                                                                                                     95                         15
   D2954        Prefabricated post and core in addition to crown                                                                                    100                         20
   D3120        Pulp cap - indirect (excluding final restoration)                                                                                    25                          0
                Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental
   D3220                                                                                                                                                60                          0
                junction and application of medicament
   D3310        Anterior (excluding final restoration)                                                                                                  290                        50
   D3320        Bicuspid (excluding final restoration)                                                                                                  360                        40
   D3330        Molar (excluding final restoration)                                                                                                     435                        75

   D4341                                                                                                                                                105                         0
            Periodontal scaling and root planing, four or more contiguous teeth or bounded teeth spaces per quadrant
   D4355    Full mouth debridement to enable comprehensive periodontal evaluation and diagnosis                                                         70                          0
            Localized delivery of chemotherapeutic agents via a controlled release vehicle into diseased
   D4381                                                                                                                                            20% Disc                        0
            crevicular tissue, per tooth, by report
   D4910    Periodontal maintenance                                                                                                                     68                          7
   D6240    Pontic - porcelain fused to high noble metal                                                                                                430                         0
   D6750    Crown - porcelain fused to high noble metal                                                                                                 490                        110
   D7111    Coronal remnants - deciduous tooth                                                                                                          40                         10
   D7140    Extraction, erupted tooth or exposed root (elevation and/or forceps removal)                                                                50                         15
            Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or
   D7210                                                                                                                                                95                         15
            section of tooth
   D7230    Removal of impacted tooth - partially bony                                                                                                150                           0
   D7240    Removal of impacted tooth - completely bony                                                                                               185                           0
D7810-D7899 Unspecified TMD therapy, by report                                                                                                      20% Disc                        0
D8010-D8999 Orthodontic retention (removal of appliances, construction and placement of retainer(s))                                                25% Disc                        0
   D9110    Palliative (emergency) treatment of dental paid - minor procedure                                                                         40                            1
   D9220    Deep sedation/general anesthesia - first 30 minutes                                                                                       160                           0
   D9230    Analgesia, anxiolysis, inhalation of nitrous oxide                                                                                        20                            0
       Underwritten or Administered by: Educators Health Plans Health, Educators Health Care, Educators Health Plans Life, Accident, and Health or Educators Mutual Insurance Association
                         Benefits illustrated are in summary only. Refer to your Group Certificate booklet for a complete description of benefits, limitations and exclusions.




                                                            Member Fees are subject to change January 1st of each year.
MR TEST
100 S ROOSEVELT ST
MURRAY, UT 84107



Dear Insured:

Welcome to EMI Health. We are pleased to provide you with your new identification cards. Please
present this card to your provider each time you receive services.

Providers may use either your social security number or the member ID number on your card when
submitting claims. All correspondence from EMI Health, including your Explanations of Benefits
(EOBs), will reference your social security number.

If you have any questions or concerns, or if you have terminated your employment, please call the
EMI Health Enrollment Department at (801) 262-7475 within the Salt Lake area, or toll free at
(800) 662-5851 in other areas of Utah.


Sincerely,
EMI Health
       000222XXEMIHFI 




                                    Detach Cards Here 
                                                            Participating Premier Providers

                                          Blamires, Michael A       Park, Kwang                                     Brinkerhoff, Matthew S
            Alpine                        476 N 900 W Ste A         483 E 200 S                 Periodontist        469 Medical Dr Ste 108
                                          (801) 756-5522            (801) 756-7173         Thunell, Daniel          (801) 298-7728
                                          Bott, Ryan                FOREIGN LANGUAGE(S):   476 N 900 W Ste A        Cannon, Hyrum
        Endodontist                       183 S 500 E               Korean                 (801) 756-5522           55 E 2200 S
  Olsen, Brady J                          (801) 763-9080            Reschke, John                                   (801) 295-5115
                                          Braithwaite, Steven R     476 N 900 W Ste A                               Chidester, Robert J
  75 W Main St Court Ste 200
  (801) 510-9570                          218 N West State Rd       (801) 756-5522                   Beaver         24 S 500 W Ste D
                                          (801) 763-7737            Richards, Bruce B                               (801) 296-1606
     General Dentist                      Cerny, William            233 E Main St             General Dentist       Curtis, Cabot
                                          483 E 200 S               (801) 756-8686                                  425 Medical Dr Ste 211
  Blackhurst, David R                     (801) 756-7173            Roberson, Jeffrey      Murdock, Hal D           (801) 397-5220
  32 Red Pine Dr Ste 14                   FOREIGN LANGUAGE(S):      476 N 900 W Ste A      55 N 400 E               Dedecker, Troy P
  (801) 756-9595                          Spanish                   (801) 756-5522         (435) 438-5109           1480 Orchard Dr Ste 110
  Braithwaite, Randy C                    Chidester, Robert J       Roberts, Kim G         Myers, Delmont G         (801) 295-9500
  32 Red Pine Dr Ste 14                   476 N 900 W Ste A         476 N 900 W Ste A      885 N 50 E               FOREIGN LANGUAGE(S):
  (801) 756-9595                          (801) 756-5522            (801) 756-5522         (435) 438-5940           Portuguese
  Downing, Randy N                        Christensen, Joseph       Schofield, Natali C                             Dickerson, Darin
  32 Red Pine Dr Ste 14                   476 N 990 W # 1           198 S 1100 E                     Pediatrics     24 S 500 W Ste D
  (801) 756-9595                          (801) 756-5522            (801) 756-7129                                  (801) 296-1606
  Faerber, David E                                                                         French, Ronald A
                                          Davies, Kendell T         Searle, Bryce          2050 Cottontree Ln       Faerber, David
  32 Red Pine Dr Ste 14                   291 N 300 E               356 E 20 S             (435) 421-1298           425 Medical Dr Ste 211
  (801) 756-9595                          (801) 756-2346            (801) 756-4595                                  (801) 397-5220
  Hart, Brody James                       Dickerson, Darin          Shoff, Carl C                                   Fisher, William C
  32 Red Pine Dr Ste 14                   476 N 900 W Ste A         76 N 100 E Ste A4
                                                                                                 Bicknell           24 S 500 W Ste D
  (801) 756-9595                          (801) 756-5522            (801) 756-0360                                  (801) 296-1606
  Hendrickson, R Heath                    Erekson, David G          Smith, Gregory            General Dentist       Flynn, David L
  32 Red Pine Dr Ste 14                   186 S 1100 E              476 N 900 W Ste A                               460 S 400 E
  (801) 756-9595                          (801) 756-5136            (801) 756-5522         Christensen, Michael T   (801) 292-1304
  McInnes, Matthew                        Fisher, William C         Steele, Richard H      128 S 300 W              Gerrard, Devin Mason
  32 Red Pine Dr Ste 14                                                                    (435) 425-3744
                                          476 N 900 W Ste A         476 N 900 W Ste A                               311 E 500 S
  (801) 756-9595                          (801) 756-5522            (801) 756-5522         Hinton, April            (801) 295-5796
  Myers, John W                           Greenwood, Brandon D      Tracy, Scott A         128 S 300 W              Greenhalgh, Jennifer
  32 Red Pine Dr Ste 14                                                                    (435) 425-3744
                                          226 N 1100 E              321 E 300 N                                     1512 Renaissance Towne Dr Ste
  (801) 756-9595                          (801) 756-6037            (801) 756-0933         Stilson, Wilford         200
  Rush, Ryan K                            FOREIGN LANGUAGE(S):      FOREIGN LANGUAGE(S):   128 S 300 W              (801) 292-2622
  32 Red Pine Dr Ste 14                   Japanese                  French/Spanish         (435) 425-3744           Hartvigsen, James L
  (801) 756-9595
                                          Greenwood, Dale M         Walker, Bradley S           Orthodontist
                                                                                                                    1325 N Main St Ste 1
  Stucki, Grant T                         226 N 1100 E              483 E 200 S                                     (801) 292-1221
  20 W Main St Ct Ste 100                 (801) 756-6037            (801) 756-7173         Oldroyd, Roger J         Hibler, G Allen
  (801) 756-3570
  FOREIGN LANGUAGE(S):
                                          Hansen, Clayton M         FOREIGN LANGUAGE(S):   130 S 300 W              1480 S Orchard Dr 107
                                          366 S 500 E               Spanish                (435) 425-3264           (801) 295-5865
  Spanish                                                                                                           Hicken, Clark B
                                          (801) 756-2809            Winder, George         FOREIGN LANGUAGE(S):
  Stucki, Randall M                       Harding, Roger K          476 N 900 W Ste A      Spanish                  24 S 500 W Ste D
  75 W Main St Ct Ste 200                 183 S 500 E               (801) 756-5522                                  (801) 296-1606
  (801) 492-7778                                                                                                    Hickman, William
                                          (801) 763-9080            Wright, Aaron D                  Pediatrics
                                          Hicken, Clark B           476 N 900 W Ste A                               24 S 500 W Ste D
       Oral Surgeon                       476 N 900 W Ste A         (801) 756-5522         Albrecht, Tyler R        (801) 296-1606
                                                                                           128 S 300 W              Johnson, Robert H
  Bluth, O Daniel                         (801) 756-5522            Young, Christopher     (435) 425-3744
  521 Wilderness Dr                       Hudson, Sascha            483 E 200 S                                     24 S 500 W Ste D
  (877) 947-8338                          483 E 200 S               (801) 756-7173                                  (801) 296-1606
                                          (801) 756-7173            FOREIGN LANGUAGE(S):        Blanding            Larsen, Paul C
       Orthodontist                       Johnson, Robert           Spanish                                         395 E 500 S
                                          476 W 900 W Ste A         Young, Michael W                                (801) 295-8881
  Stucki, Grant T                         (801) 756-5522            483 E 200 S
                                                                                              General Dentist       FOREIGN LANGUAGE(S):
  20 W Main St Ct Ste 100                 Liddle, Joseph D          (801) 756-7173         Macdonald, Paul R        Spanish
  (801) 756-3570                                                                                                    Lindgren, Jeremiah M
                                          120 N Center St                                  401 S Main St
  FOREIGN LANGUAGE(S):
  Spanish
                                          (801) 756-3377                 Orthodontist      (435) 678-2815           24 S 500 W Ste D
                                          Lindgren, Jeremiah M                             Olsen, Brian F           (801) 296-1606
                                          476 N 900 W Ste A         Price, Cory D          799 S 200 W              Lindsay, Stuart
      American                            (801) 756-5522            476 N 900 W Ste A
                                                                    (801) 756-5522
                                                                                           (435) 678-3601           425 Medical Dr Ste 211
                                                                                                                    (801) 397-5220
                                          Loeser, Michael
        Fork                              483 E 200 S               Rosvall, Michael D
                                                                                                Bountiful           Mackay, Matthew H
                                          (801) 756-7173            224 S 1100 E                                    280 N 200 W Ste 100
                                          FOREIGN LANGUAGE(S):      (801) 763-9143                                  (801) 397-2323
        Endodontist                                                 FOREIGN LANGUAGE(S):
                                          Spanish
                                                                    Spanish                     Endodontist         FOREIGN LANGUAGE(S):
  Christensen, Joseph D                   Macdonald, David                                                          Spanish
  36 S 1100 E Ste B                       148 S 1100 E              Talbot, Travis Q       Christensen, Joseph D    Mattinson, Craig J
  (801) 822-9876                                                    148 S 1100 E           24 S 500 W Ste D
                                          (801) 756-6048                                   (801) 296-1606           1355 N Main St Ste 9
  Watts, Robert K                                                   (801) 772-0606                                  (801) 294-3345
                                          Meeks, Daniel             Watson, Jeremy R       Olsen, Brady J
  476 N 900 W Ste A                       476 N 900 W Ste A
                                                                                           185 S 400 E Ste 201
                                                                                                                    Meeks, Daniel
  (801) 756-5522                          (801) 756-5522            496 N 990 W Ste G                               24 S 500 W Ste D
                                                                    (801) 763-7977         (801) 510-9570
                                          Menlove, Benjamin                                                         (801) 296-1606
     General Dentist                      476 N 900 W Ste A                                                         Menlove, Benjamin
                                          (801) 756-5522                      Pediatrics      General Dentist       24 S 500 W Ste D
  Anderson, John A
  170 N Center St                         Muir, Eric B              Reading, Tyler         Adams, A Paul            (801) 296-1606
  (801) 756-2341                          28 S 1100 E Ste A         476 N 900 W Ste A      311 E 500 S              Olsen, Phillip P
  Austad, Thomas N                        (801) 756-4989            (801) 756-5522         (801) 295-5796           24 S 500 W Ste D
  476 N 900 W Ste A                       FOREIGN LANGUAGE(S):      Rupp, Jeffery K        Albertelli, Robert       (801) 296-1606
  (801) 756-5522                          Spanish                   476 N 900 W Ste A      319 S Main St            Oman, Gregory G
                                          Murdock, Bruce T          (801) 756-5522         (801) 295-7171           1480 Orchard Dr Ste 111
  Baird, Daniel R
  101 N West State Rd Ste 108             356 E 20 S                Smith, Nathan E        Austad, Thomas N         (801) 298-9441
  (801) 492-9207                          (801) 756-4595            148 S 1100 E           24 S 500 W Ste D         Reading, Tyler
                                          Olsen, Phillip            (801) 756-6048         (801) 296-1606           24 S 500 W Ste D
  Bateman, Joshua M
  218 N Center St                         476 N 900 W Ste A                                Blamires, Michael A      (801) 296-1606
  (801) 756-5019                          (801) 756-5522                                   24 S 500 W Ste D
                                                                                           (801) 296-1606



(*) Accepting Established Patients ONLY                                                                                           Page 1
                                                             Participating Premier Providers

                                                                          Barrick, Robert L                                        Trotter, Howard A
        Bountiful                              Periodontist               1883 W Royal Hunte Dr Ste 100      Centerville           170 W 1800 N
                                          Chaston, Reve                   (435) 586-6541                                           (801) 773-1533
        (Cont'd)                          24 S 500 W Ste D                Brown, Gregory H                                         Waldron, Ryder
                                          (801) 296-1606                  415 N Main St Ste 301              General Dentist       170 W 1800 N
                                                                          (435) 586-3885                  Arbuckle, Jeffrey G      (801) 773-1533
      General Dentist                                                     Brown, Scott H
         (Cont'd)                          Brigham City                   415 N Main St Ste 301
                                                                                                          281 S Main St
                                                                                                          (801) 292-0733                Oral Surgeon
                                                                          (435) 586-3885                  Arbuckle, Kent K
  Reschke, John                                                           Brown, Shawn H                                           Jessen, G Shane
                                             General Dentist                                              281 S Main St            1448 N 2000 W Ste 12
  24 S 500 W Ste D                                                        415 N Main St Ste 301           (801) 292-0733           (801) 479-8200
  (801) 296-1606                          Adams, Douglas R                (435) 586-3885                  Asay, Gaylen             FOREIGN LANGUAGE(S):
  Roberson, Jeffrey                       990 Medical Dr Ste G1           Davies, D Alan
                                          (435) 723-6113                                                  1090 S 400 E             Spanish
  24 S 500 W Ste D                                                        1251 Northfield Rd Ste 310      (801) 292-4440
  (801) 296-1606                          Adams, Jody                     (435) 586-9055                                           Newey, Mark
                                          241 W Forest St
                                                                                                          Dastrup, Kent A          938 University Park Blvd Ste 100
  Smith, Gregory                                                          Fackrell, Craig D               281 S Main St Ste 5      (801) 825-1116
  24 S 500 W Ste D                        (435) 723-6120                  395 S 100 W
                                          FOREIGN LANGUAGE(S):                                            (801) 292-0411
  (801) 296-1606                                                          (435) 586-3849                  Huffaker, David M
  Steele, Richard H                       Spanish                         Faulkner, Davin                 134 S Main St                      Clinton
  24 S 500 W Ste D                        Bateman, Ryan V                 110 W 1325 N Ste 125            (801) 292-5172
  (801) 296-1606                          2535 S Highway 89 Ste 1         (435) 586-3884
                                          (435) 723-4300                                                  Huffaker, Ford B            General Dentist
  Taylor, Colleen P                                                       FOREIGN LANGUAGE(S):            134 S Main St
  535 Medical Dr                          Benson, Brady E                 Spanish                         (801) 292-5172           Hess, Jason G
  (801) 292-2828                          111 E Forest St Ste F           Gunn, Ryan S                                             1448 N 2000 W Ste 1
                                          (435) 723-2318                                                  Huffaker, Todd B
  Toone, Kent J                                                           409 S Main St                   134 S Main St            (801) 774-5200
  460 S 400 E                             Butler, Brent S                 (435) 865-9797                  (801) 292-5172           Roring, John L
  (801) 295-5585                          305 N Main St                   Harward, Brian S                FOREIGN LANGUAGE(S):     2207 W 1800 N
  FOREIGN LANGUAGE(S):                    (435) 734-2626                  1760 N Main St Ste 103                                   (801) 825-3993
                                                                                                          German
  Spanish                                 Capener, Randell M              (435) 867-0644                  Pitt, Bruce G
                                          515 W Forest St
  Vernon, Andrew M
  24 S 500 W Ste D                        (435) 723-6211
                                                                          Henderson, Brandon D
                                                                          1760 N Main St Ste 103
                                                                                                          281 S Main St                 Coalville
                                                                                                          (801) 295-6192
  (801) 296-1606                          Daines, Howard R                (435) 867-0644                  Pitt, Jason M
  Winder, George                          104 W 200 S                     Ludlow, Jeremy L                281 S Main St               General Dentist
  24 S 500 W Ste D                        (435) 734-2394                  110 W 1325 N                    (801) 295-6192           Crowther, Glade R
  (801) 296-1606                          Mackley, Mark D                 (435) 586-3884                  Pitt, Jerem M
                                          2535 S Highway 89 Ste 1                                                                  60 S Main St
  Woodward, Brandon                                                       Morris, Shad L                  281 S Main St            (435) 336-2657
  425 Medical Dr Ste 211                  (435) 723-4300                  427 S Main St Ste 101           (801) 295-6192
  (801) 397-5220                          Murdock, Mark B                 (435) 586-6526                  Ramsdell, Christopher
  Wright, Aaron D                         30 E 700 S                      Sorensen, James                 M
                                                                                                                                    Cottonwood
                                          (435) 734-2248
  24 S 500 W Ste D
  (801) 296-1606                          FOREIGN LANGUAGE(S):
                                                                          1883 W Royal Hunte Dr Ste 100
                                                                          (435) 586-6541
                                                                                                          1080 S 400 E                Heights
                                          Spanish                                                         (801) 292-4449
                                                                          Sorensen, Shannon W
        Oral Surgeon                      Nelson, Daniel K                415 N Main St Ste 302                                         Endodontist
  Chandler, Jason G
                                          104 W 200 S                     (435) 586-0997                  Central Valley           Facer, Steven R
                                          (435) 734-2394                  Tavoian, Brian K
  469 Medical Dr Ste 202                  Olson, Aaron M                                                                           7138 Highland Dr Ste 109
  (801) 299-8531                                                          510 S Main St                      General Dentist       (801) 942-8686
                                          105 Skyline Dr                  (435) 586-0123
  FOREIGN LANGUAGE(S):                    (435) 723-8913                  White, Sage L                   Chisholm, Richard T
  Spanish                                 FOREIGN LANGUAGE(S):            747 S Paradise Canyon Rd        30 S Main St                General Dentist
  Dedecker, Dennis L                      Portuguese                      (435) 586-9991                  (435) 527-3555           Menlove, Benjamin R
  625 E 500 S Ste 204                     Peterson, Dennis W                                              FOREIGN LANGUAGE(S):
  (801) 298-2242                                                          Williams, Chase M                                        7050 Highland Dr Ste 110
                                          14 N 100 E                      510 S Main St                   Spanish                  (801) 943-3233
  Israelsen, L Douglas                    (435) 723-8276                  (435) 586-9543                                           FOREIGN LANGUAGE(S):
  1551 S Main St Ste 540                  Ramsdell, Christopher
  (801) 397-2727
                                          M                                   Oral Surgeon
                                                                                                              Clearfield           Portuguese
  Liston, Todd C                          14 N 100 E                                                                                    Oral Surgeon
  469 Medical Dr Ste 202                  (435) 723-8276                  Davis, Shawn B                     General Dentist
  (801) 299-8531
                                          Sutton, Phillip J               66 W Harding Ave Ste A                                   Israelsen, L Douglas
                                          102 E Forest St
                                                                          (877) 628-1121                  Carlton, Scott           6710 Blackstone Rd Ste 201
            Orthodontist                  (435) 734-2364                  Dudley, Wayne H                 1435 S 1350 E            (801) 397-2727
                                                                          415 N Main St Ste 204           (801) 774-6567           Partridge, Judd E
  Clark, Rdean M                          Walton, Troy R                  (435) 867-1474                  Cox, Kevin G             7138 Highland Dr Ste 211
  24 S 500 W Ste D                        14 N 100 E
  (801) 296-1606                          (435) 723-8276                  Mizukawa, John H                975 S State St           (801) 943-8703
                                                                          415 N Main St Ste 204           (801) 773-5914
  Holman, Brian G                         FOREIGN LANGUAGE(S):
                                                                          (435) 867-1474                  Day, John W                        Pediatrics
  469 Medical Dr Ste 208                  Spanish
                                                                                                          573 N 1000 W
  (801) 292-3506                          Warren, Mark                         Orthodontist               (801) 776-1000           Burg, Jeff
  FOREIGN LANGUAGE(S):                    14 N 100 E                                                                               7050 Highland Dr Ste 110
  Italian                                 (435) 723-8276                  Anderton, Kirk J                Goupios, Peter G         (801) 943-3233
                                                                                                          573 N 1000 W
  Holman, R Gayle                                                         1751 W Royal Hunte Dr           (801) 776-1000           Knudson, Darin
  469 Medical Dr                               Orthodontist               (435) 865-9111                  FOREIGN LANGUAGE(S):     7050 Highland Dr Ste 110
  (801) 292-3506
                                          Blanchard, Steven T             Webster, Mark J                 Greek                    (801) 943-3233
  FOREIGN LANGUAGE(S):
                                          105 Skyline Dr
                                                                          415 N Main St Ste 304
                                                                                                          Goupios, Robert          Smyth, Chester K
  Spanish                                 (435) 723-9200
                                                                          (435) 867-9172                                           7050 Highland Dr Ste 110
                                                                                                          573 N 1000 W             (801) 943-3253
             Pediatrics                   Knudson, Peter C                          Pediatrics            (801) 776-1000
                                          105 Skyline Dr                                                  Mackley, Paul A
  Mandelaris, Jason G                     (435) 723-6366                  Albrecht, Tyler R               2207 W 1800 N Ste A                 Delta
  55 E 2200 S                                                             1251 Northfield Rd Ste 201      (801) 825-3993
  (801) 295-5115
                                             Cedar City                   (435) 586-8188                  Robins, Christopher         General Dentist
  Nelson, Mark L                                                                                          255 N 3000 W Ste A
  1551 Renaissance Towne Dr Ste
  540                                        General Dentist
                                                                             Cedar Hills                  (801) 784-9000
                                                                                                          Scoville, R Kent
                                                                                                                                   Church, Craig S
                                                                                                                                   85 N Center St
  (801) 295-8322                                                                                          466 N Main St Ste 101    (435) 864-4623
  FOREIGN LANGUAGE(S):                    Barrick, Michael                   General Dentist              (801) 776-8441           Myers, Joseph W
  Spanish                                 1883 W Royal Hunte Dr Ste 100
                                          (435) 586-6541                  Lorscheider, M Sean             Scoville, Ronald James   86 White Sage Ave
                                                                                                          466 N Main St Ste 101    8014358642002
                                                                          10060 N 4600 W
                                                                          (801) 492-0402                  (801) 776-8441




(*) Accepting Established Patients ONLY                                                                                                          Page 2
                                                           Participating Premier Providers

                                          Lucero, Robert M               Iverson, Vern Q
  Delta (Cont'd)                          856 E 12300 S Ste 8
                                          (801) 553-9824
                                                                         2627 N Highway 162
                                                                         (801) 745-3882
                                                                                                     Farr West                Gunnison
                                          FOREIGN LANGUAGE(S):           Larsen, Paul C
     General Dentist                      Spanish/Portuguese             2627 N Highway 162         General Dentist          General Dentist
        (Cont'd)                          Myers, John W                  (801) 745-3882          Osofsky, Stuart W        Frandsen, Kelly M
                                          219 E 12300 S Ste I5                                   1812 N 2000 W Ste 8      75 N 100 E
  Stucki, Scott C                         (801) 495-4440
                                          Noorda, Matthew L
                                                                            Enterprise           (801) 731-4440           (435) 528-7316
  372 W Main St                                                                                                           Larson, Ernest M
                                          12226 S 1000 E Ste 8
  (435) 864-2120
                                          (801) 553-2350                    General Dentist            Fillmore           85 N 100 E
                                                                                                                          (435) 528-7266
       Oral Surgeon                       Parker, Richard G              Cope, Benjamin D
  Davis, Shawn B
                                          112 E 12450 S Ste A-102
                                          (801) 302-8897
                                                                         223 S 200 E                General Dentist            Orthodontist
  86 White Sage Ave                                                      (435) 878-2775          Beckstrand, J Bruce      Oldroyd, Roger J
                                          Spangler, Seth N
  (877) 628-1121                          10 Scenic Pointe Dr Ste 105                            140 S Main St            85 N 100 E
                                          (801) 816-9990                      Ephraim            (435) 743-6521           (435) 528-7316
       Orthodontist                       FOREIGN LANGUAGE(S):                                                            FOREIGN LANGUAGE(S):
  Burke, Brandon G                        Chinese                                                     Orthodontist        Spanish
                                          Woodbury, Spencer
                                                                            General Dentist
  86 White Sage Ave                                                                              Oldroyd, Roger J
  (435) 652-6144                          112 E 12450 S Ste 101
                                          (801) 571-5354
                                                                         Thompson, Connor L
                                                                         35 E 400 S
                                                                                                 61 S Main St                Heber City
  Oldroyd, Roger J                                                                               (435) 743-6178
  262 N 300 E                                                            (435) 283-4081          FOREIGN LANGUAGE(S):
  (435) 864-3881                              Oral Surgeon               Thompson, Leland R      Spanish                     General Dentist
  FOREIGN LANGUAGE(S):                                                   35 E 400 S                                       Ford, Kraig R
  Spanish
                                          Flint, Robert L                (435) 283-4081
                                          114 E 12450 S Ste 104          Thompson, Wesley B        Garden City            340 N Main St
                                                                                                                          (435) 654-2020
                                          (801) 576-5910
                                                                         35 E 400 S                                       Jensen, Brandon C
            Draper                        FOREIGN LANGUAGE(S):
                                          Spanish
                                                                         (435) 283-4081             General Dentist       340 N Main St
                                                                         FOREIGN LANGUAGE(S):                             (435) 654-2020
     General Dentist                                                     Mandarin                Cole, Daren C            Lobrot, Reed D
                                               Orthodontist                                      325 W Logan Hwy
                                                                                                                          380 E 1500 S Ste 203
  Babcock, David M                                                                               (435) 446-3660
  112 E 12450 S Ste 100
                                          Ghiz, Matthew A
                                          112 E 12450 S Ste 100
                                                                              Fairview           Moss, Douglas
                                                                                                                          (435) 654-4500
  (801) 571-6751                                                                                 325 W Logan Hwy          McNaughtan, Benjamin
                                          (801) 571-6751
  Boyden, Robert D                                                          General Dentist      (435) 946-3660           J
                                          Young, David V                                         FOREIGN LANGUAGE(S):     750 W 100 S
  11576 S State St Ste 1201               12226 S 1000 E Ste 6
  (801) 576-1799                          (801) 523-9333
                                                                         Bench, Steven           Spanish                  (435) 654-1202
  Christensen, Devin                                                     229 S State St                                   Ogilvie, Ralph
                                                                         (435) 427-3322               Orthodontist        425 E 1200 S
  114 E 12450 S Ste 102
  (801) 576-1100
                                                    Pediatrics                                                            (435) 654-4004
  Dastrup, N Jared                        Allen, Spencer T                 Farmington            Smith, Darrel G          Probst, Kent T
                                          112 E 12450 S Ste 100A                                 325 W Logan Hwy          620 W 100 S Ste B
  12465 Fort St Ste 100                                                                          (435) 928-4579
  (801) 576-1167                          (801) 571-6751                                                                  (435) 654-4009
  Dehart, Brent                           Moffat, Ryan                      General Dentist
  114 E 12450 S Ste 200                   114 E 12450 S 200              Call, Brian D                 Garland                Oral Surgeon
  (801) 495-1610                          (801) 495-1610                                                                  Haymond, Creed S
                                                                         1433 N 1075 W Ste 100
  Faddis, Kelly A                         Stark, Cory M                  (801) 451-6222                                   160 S 100 W
                                          112 E 12450 S Ste A100                                    General Dentist
  11760 S 700 E Ste 110
                                          (801) 571-6751
                                                                         Corry, Scott W                                   (435) 654-5459
  (801) 571-6688                                                         88 E State St           Goodwin, Dustin V
  Fischer, David V                        FOREIGN LANGUAGE(S):                                   75 E 1400 S
  11576 S State St Ste 1203               Spanish
                                                                         (801) 451-2341
                                                                         King, David R           (435) 257-7016                     Helper
  (801) 619-8664                                                         88 E State St
  Glassett, Nelson D                            Eagle                    (801) 451-2341              Oral Surgeon            General Dentist
  11576 S State St Ste 1203                                              Packer, P Berrett       Anderson, Gregory E
  (801) 619-8664                               Mountain                  88 E State St           1335 S Main St Ste 102
                                                                                                                          Hanson, Dorr W
                                                                                                                          48 S Main St
  FOREIGN LANGUAGE(S):                                                   (801) 451-2341          (435) 755-5000
  Spanish/Portuguese                                                                                                      (435) 472-5556
                                             General Dentist             Packer, P Craig                                  Hanson, Eric
  Goeckeritz, Chad                                                       88 E State St
  112 E 12450 S Ste 101                   Hart, Ryan R                   (801) 451-2341             Grantsville           48 S Main St
                                                                                                                          (435) 472-5556
  (801) 495-3567                          3566 Pony Express Pkwy Ste 1   Palmer, Bradley C
  Hall, Aaron C                           (801) 789-7500
  1442 Draper Pkwy                        Nance, Brady M
                                                                         56 S 200 E
                                                                         (801) 451-2841
                                                                                                    General Dentist           Herriman
  (801) 571-9555                          3566 Pony Express Pkwy Ste 1   Palmer, Brian S         Allred, Aaric J
  Holt, Nathan C                          (801) 787-7500                 56 S 200 E              225 E Main St Ste G
  219 E 12300 S Ste I5                                                   (801) 451-2841          (435) 884-3088              General Dentist
  (801) 495-4440                               Orthodontist                                      FOREIGN LANGUAGE(S):     Blackhurst, David R
  Jarman, Dean                                                                Orthodontist       Spanish                  6351 W 13400 S
                                          Nord, Scott C                                          Curtis, C Blaine         (801) 302-7808
  11576 S State St Ste 302                3688 Campus Dr Ste 220
  (801) 576-0200                                                         Endrizzi, Mark T        14 N Hale St             Braithwaite, Randy C
                                          (801) 789-5444                 193 S 200 W
  Jensen, Tony M                                                                                 (435) 884-3476           6351 W 13400 S
                                                                         (801) 447-6707          FOREIGN LANGUAGE(S):     (801) 302-7808
  12226 S 1000 E Ste 4                              Pediatrics           FOREIGN LANGUAGE(S):
  (801) 571-6663                                                                                 German                   Clegg, David T
                                          Martin, Eric E                 Spanish                 Dansie, Dan W
  Johnson, Christopher S                                                                                                  5069 W 13400 S Ste 200
  12288 S 900 E                           3688 Campus Dr Ste 220         Young, David V          822 E Main St Ste A      (801) 253-8824
  (801) 501-0209                          (801) 341-7999                 56 S 200 E              (435) 884-3002           Downing, Randy
                                                                         (801) 266-3578
  Johnson, Kent N                                                                                                         6351 W 13400 S
  12288 S 900 E
  (801) 501-0209
                                                     Eden                          Pediatrics      Green River            (801) 302-8787
                                                                                                                          Faerber, David E
  Liu, Lloyd K                                                           Anderson, John R                                 6351 W 13400 S
  432 E 12300 S Ste 8                        General Dentist             1401 N 1075 W Ste 200      General Dentist       (801) 302-7808
  (801) 553-2588                          Baldwin, Cade G                (801) 447-5437          Larsen, Clyde            Fairbanks, Jon C
  FOREIGN LANGUAGE(S):                    2640 N Highway 162 Ste 101                                                      5514 W 13400 S
                                                                                                 585 W Main St
  Chinese                                 (801) 745-1100                                         (435) 564-3434           (801) 446-9533
                                          Crookston, Michael                                     Miller, Gerald O         Hart, Brody James
                                          2640 N Highway 162 Ste 101                             585 W Main St            6351 W 13400 S
                                          (801) 745-1100                                         (435) 564-3434           (801) 302-7808



(*) Accepting Established Patients ONLY                                                                                                Page 3
                                                           Participating Premier Providers

                                                                                                 Chidester, Robert J              Smith, Gregory
       Herriman                               Huntsville                 Kaysville               1492 W Antelope Dr Ste 201
                                                                                                 (801) 776-6566
                                                                                                                                  1492 W Antelope Dr Ste 201
                                                                                                                                  (801) 776-6566
       (Cont'd)                                                                                  Dastrup, Kent A                  Spainhower, David
                                             General Dentist           General Dentist           1492 W Antelope Dr Ste 201       2112 N Hill Field Rd Ste 2-A
                                          Dacquel Clem, Joy         Barton, Jason G              (801) 776-6566                   (801) 775-8005
     General Dentist                                                                             Denning, Don W                   Steele, Richard H
                                          237A S 7400 E             302 N Main St
        (Cont'd)                          (801) 745-1222            (801) 544-3953               525 N Fairfield Rd               1492 W Antelope Dr Ste 201
                                                                    FOREIGN LANGUAGE(S):         (801) 544-9717                   (801) 776-6566
  Hendrickson, R Heath                                              Spanish                      Dickerson, Darin                 Vernon, Andrew M
  6321 W 13400 S                              Hurricane             Flynn, Robert M              1492 W Antelope Dr Ste 201       1492 W Antelope Dr Ste 201
  (801) 302-7808                                                                                 (801) 778-8588                   (801) 776-6566
                                                                    206 S Main St
  Lambert, Jeffrey                           General Dentist        (801) 497-0619               Eaton, Jason W                   Wible, Darren J
  5734 W 13400 S Ste 100                                            Gray, Eric T                 1916 Layton Hills Pkwy Ste 100   2112 N Hill Field Rd Ste 1
  (801) 302-0222                          Demille, Maurice C        475 N 300 W Ste 16           (801) 525-2200                   (801) 774-0770
  McInnes, Matthew                        50 S 700 W                                             Egan, Kelly C                    Wilcox, Wesley H
                                          (435) 635-4492            (801) 543-2220
  6351 W 13400 S                                                    Jensen, Dan B                70 W Gordon Ave                  360 S Fort Ln Ste B100
  (801) 302-7808                          FOREIGN LANGUAGE(S):                                   (801) 544-3844                   (801) 544-9777
                                          Spanish                   47 Crestwood Rd Ste 3
  Morrison, Jeffrey S                                               (801) 544-4204               Finlinson, Clark R               Winder, George
  6351 W 13400 S                          French, Jared T           Miller, Mark T               195 E Gentile St Ste 1           1492 W Antelope Dr Ste 201
  (801) 302-7808                          82 S 700 W                                             (801) 544-1818                   (801) 776-6566
                                          (435) 635-4333            307 N 300 W Ste 304
  Peterson, John M                                                  (801) 544-4003               FOREIGN LANGUAGE(S):             Woodbury, William E
  12427 S 4000 W Ste 200                  FOREIGN LANGUAGE(S):                                   Japanese                         195 E Gentile St Ste 12
  (801) 254-8812                          Spanish                   Morgan, Christopher T
                                                                    47 Crestwood Rd Ste 5        Fisher, William C                (801) 546-0007
  Rush, Ryan K                            Hatch, Jeremy D           (801) 546-2439               1492 W Antelope Dr Ste 201       Wright, Aaron D
  6351 W 13400 S                          52 S 850 W Ste 201                                     (801) 776-6566                   1492 W Antelope Dr Ste 201
  (801) 302-7808                          (435) 635-9471            Morgan, Kyle S
                                                                    47 Crestwood Rd Ste 5        Frost, Ron A                     (801) 776-6566
  Sorensen, Steven E                      Heaton, Kenneth W         (801) 546-2439               1868 N Hill Field Rd Ste 110
  6351 W 13400 S                          50 S 700 W
                                                                    Morgan, Stephen S            (801) 774-8190                        Oral Surgeon
  (801) 302-7808                          (435) 635-4492                                         FOREIGN LANGUAGE(S):
                                                                    47 Crestwood Rd Ste 5                                         Benson, Paul D
                                          Lundeen, Kelly J          (801) 546-2439               Spanish
                                                                                                                                  890 Heritage Park Blvd Ste 103
       Orthodontist                       75 S 300 W
                                                                    Pope, Marcus R               Gardner, Timothy A               (801) 614-0999
                                          (435) 635-5940                                         525 N Fairfield Rd
  Rosvall, Michael D                      Rowe, Michael             302 N Main St
                                                                                                 (801) 444-9911
                                                                                                                                  Broadbent, Michael
  13178 S 5600 W                                                    (801) 544-3953                                                2297 N Hill Field Rd Bldg A
                                          82 S 700 W                FOREIGN LANGUAGE(S):         Harmon, Kyle K
  (801) 253-6645                          (435) 635-4333                                                                          (801) 779-0506
  FOREIGN LANGUAGE(S):                                              Portuguese                   360 S Fort Ln Ste B100           Chandler, Jason G
  Spanish                                 Wells, Mason S            Richardson, Jared L          (801) 544-9777
                                          50 S 700 W                                                                              2297 N Hill Field Rd Bldg A
                                                                    47 Crestwood Rd Ste 5        FOREIGN LANGUAGE(S):             (801) 779-0506
                                          (435) 635-4492                                         Spanish
                                                                    (801) 546-2439                                                FOREIGN LANGUAGE(S):
       Highland                                                     Steiner, John E              Hendrickson, R Heath             Spanish
                                               Orthodontist                                      2112 N Hill Field Rd Ste 101
                                                                    47 Crestwood Rd Ste 4
                                                                                                 (801) 774-0770
                                                                                                                                  Dedecker, Dennis L
     General Dentist                      Burke, Brandon G          (801) 544-0091                                                2185 N 1700 W Ste 204
                                          48 S 2500 W Ste 230                                    Hicken, Clark B                  (801) 773-9790
  Alcorn, James                           (435) 635-3200                      Pediatrics         1492 W Antelope Dr Ste 201       Liston, Todd C
  5455 W 11000 N Ste 103                  Simister, Bradley G                                    (801) 776-6566
  (801) 492-0055                                                    Jones, M Brandon                                              2297 N Hill Field Rd Bldg A
                                          52 S 850 W                                             Jackson, Brett R                 (801) 779-0506
  FOREIGN LANGUAGE(S):                    (435) 635-5144            250 W 200 N Ste 6            1868 N Hill Field Rd Ste 110
  Spanish                                 FOREIGN LANGUAGE(S):      (801) 544-3323               (801) 774-8198
  Clark, Kyle W                           Spanish                   Thomas, Stuart M             Johnson, Robert
                                                                                                                                       Orthodontist
  5255 W 11000 N                          Simister, Jeffrey R       250 W 200 N Ste 6            1492 W Antelope Dr Ste 201       Mortensen, Micah G
  (801) 763-2300                                                    (801) 544-3323               (801) 776-6566                   195 E Gentile St Ste 11
                                          52 S 850 W
                                          (435) 635-5144                                         Lindgren, Jeremiah               (801) 544-1184
            Holden                                                      La Verkin                1492 W Antelope Dr Ste 201       Pack, Leland W
                                                                                                                                  2112 N Hill Field Rd Ste 1
                                                    Pediatrics                                   (801) 776-6566
                                                                                                                                  (801) 774-0770
                                                                                                 Meeks, Daniel
     General Dentist                      Albrecht, Tyler              General Dentist           1492 W Antelope Dr Ste 201       Price, Cory D
                                          48 S 2500 W Ste 230                                    (801) 776-6566                   1492 W Antelope Dr Ste 201
  Larsen, James D                         (435) 635-7200            Howard, Hugh J                                                (801) 776-6566
  50 N Main                                                         144 S State St               Menlove, Benjamin
  (435) 795-2306
                                          Albrecht, Tyler R         (435) 635-4244               1492 W Antelope Dr Ste 201
  Stephenson, James W
                                          48 S 2500 W Ste 230                                    (801) 776-6566                             Pediatrics
                                          (435) 635-7200
  50 N Main                                                                   Layton             Neil, Rachelle                   Arkoudas, Wade
  (435) 795-2306                                                                                 3225 W Gordon Ave Ste 4          2112 N Hill Field Rd Ste 1
                                                    Hyrum                                        (801) 547-8800                   (801) 774-0770
       Holladay                                                           Endodontist            Neil, Scott James                Powell, Leland
                                                                                                 3225 W Gordon Ave Ste 4          2112 N Hill Field Rd Ste 1
                                             General Dentist        Christensen, Joseph D        (801) 547-8800                   (801) 774-0770
                                                                    1492 W Antelope Dr Ste 201   Neville, Jeff
     General Dentist                      Groll, Shawn R            (801) 776-6566
  Smart, J. Richard
                                          26 W Main St
                                                                    Watts, Robert K
                                                                                                 743 King St Ste 300
                                                                                                 (801) 543-2273
                                                                                                                                        Periodontist
                                          (435) 245-5866
  2180 E 4500 S Ste 250                                             1492 W Antelope Dr Ste 201   Olsen, Phillip                   Chaston, Reve
  (801) 272-8609                                                    (801) 776-6566                                                2185 N 1700 W Ste 201
  Soelberg, Steven B                                 Ivins                                       1492 W Antelope Dr Ste 201
                                                                                                 (801) 776-6566                   (801) 728-3388
  2200 E 4500 S Ste 100                                                General Dentist           Pierson, Blaine R                Thunell, Daniel
  (801) 288-1888                                                                                                                  1492 W Antelope Dr Ste 201
                                             General Dentist        Austad, Thomas N             360 S Fort Ln Ste 101
                                                                                                                                  (801) 776-6566
                                                                    1492 W Antelope Dr Ste 201   546-1231
       Orthodontist                       Leydsman, Steve R         (801) 776-6566               FOREIGN LANGUAGE(S):
                                          272 E Center St Ste 205
  Iverson, Jeffrey A                      (435) 652-8111            Babcock, David               Spanish/Portuguese                          Lehi
  1580 E 3900 S Ste 110                                             2112 N Hill Field Rd Ste 1   Reading, Tyler
  (801) 571-9663                                                    (801) 774-0770               1492 W Antelope Dr Ste 201
                                                    Kanab           Blamires, Michael A          (801) 776-6566                      General Dentist
                                                                    1492 W Antelope Dr Ste 201   Reschke, John                    Bateman, Blaine S
                                                                    (801) 776-6566               1492 W Antelope Dr Ste 201       2961 W Maple Loop Dr Ste 110
                                               Orthodontist         Brown, Jennifer              (801) 776-6566                   (801) 766-4042
                                          Webster, Mark J           2112 N Hill Field Rd Ste 1   Roberson, Jeffrey                Blackhurst, David
                                          76 E 100 S                (801) 774-0770               1492 W Antelope Dr Ste 201       1314 Redwood Rd Ste 102
                                          (435) 867-9172                                         (801) 776-6566                   (801) 768-0440




(*) Accepting Established Patients ONLY                                                                                                          Page 4
                                                           Participating Premier Providers

                                          Viehweg, Tate                     Larson, Anthony L
   Lehi (Cont'd)                          3300 Running Creek Way Ste        40 W Cache Valley Blvd Ste 2A             Manti                      Oral Surgeon
                                          H210                              (435) 787-8207                                                   Stosich, Alvin J
                                          (801) 766-4834                    Mackley, Paul                                                    7001 S 900 E Ste 100
     General Dentist                      FOREIGN LANGUAGE(S):              40 W Cache Valley Blvd Ste 2A      General Dentist               (801) 566-5117
        (Cont'd)                                                            (435) 787-8207                  Aste, R
                                                    Pediatrics              Mortenson, Celeste C
  Blackhurst, Steven                      Pearson, Jared D                  290 N 200 E
                                                                                                            93 S Main St
                                                                                                            (435) 835-4881
                                                                                                                                                       Moab
  216 E Main St Ste 1                     588 E Main St                     (435) 753-0505                  Douglas, Colton C
  (801) 768-9241                          (801) 766-2111                    Olson, Andrew C                 36 N Main St                        General Dentist
  Braithwaite, Randy C                                                      167 E 200 N Ste 6               (435) 835-4084
                                                                            (435) 752-2704                                                   Barber, Norman C
  1314 Redwood Rd Ste 102
  (801) 768-0440
                                                    Lindon                  Peery, Samuel L                      Orthodontist                380 N 500 W
                                                                            30 N 100 E                                                       (435) 259-4059
  Brooks, Leslie Graff                                                      (435) 752-1362                  Oldroyd, Roger J
  325 E 100 N                                General Dentist
  (801) 768-9471
                                          Healey, Scott M
                                                                            Priebe, Brandon M               36 N Main St
                                                                                                            (888) 416-7645
                                                                                                                                               Montezuma
  Brown, Jerry V                                                            1451 N 200 E Ste 200
  588 E Main St
                                          530 N State St                    (435) 753-4400                  FOREIGN LANGUAGE(S):                 Creek
                                          (801) 785-0584                    FOREIGN LANGUAGE(S):            Spanish
  (801) 768-8028
                                          Ulm, Sean                         Spanish
  Davis, Ryan B                                                                                                                                 General Dentist
  216 E Main St Ste 1
                                          389 W 600 N
                                          (801) 796-6882
                                                                            Schvaneveldt, Brandon                Mapleton                    Olsen, Brian F
  (801) 768-9241                                                            40 W Cache Valley Blvd Ste 4A
                                                                            (435) 752-1434                                                   East Hwy 262 PO Box 130
  Downing, Randy N                                  Pediatrics                                                 General Dentist               (435) 651-3291
  1314 Redwood Rd Ste 102                                                   Smith, Douglas
  (801) 768-0440                          Mandelaris, Jason G               160 E 200 N Ste J               Griffiths, Benjamin M            Vreeken, Joseph
                                                                            (435) 752-4882                                                   PO Box 130
  Ferrell, D. Terry                       275 W 200 N Ste 175                                               108 N 1600 W
                                                                                                                                             (435) 651-3291
  325 E 100 N                             (801) 769-2530                    Suisse, Brent                   (801) 491-6844
  (801) 766-3700                          Segura, Stuart D                  40 W Cache Valley Blvd Ste 2A   Westmoreland, Tanya P
  Gordon, David P                         275 W 200 N Ste 175               (435) 787-8207
                                                                            FOREIGN LANGUAGE(S):
                                                                                                            425 N Main St                       Monticello
  323 E 100 N                             (801) 769-2530                                                    (801) 491-8191
  (801) 766-6344                                                            Spanish
                                                                            Theurer, Scott L                                                    General Dentist
  Hadfield, Randal L
  3300 Running Creek Way Ste
                                                    Logan                   1340 N 600 E Ste 1
                                                                                                                  Midvale                    Goodwine, Brian
  C100                                                                      (435) 752-2230                                                   217 S 100 W
  (801) 768-4072                             General Dentist                Thornley, Mark J                   General Dentist               (435) 587-2528
  Hart, Body James                        Anderson, Paul D
                                                                            104 E 200 N Ste 104
                                                                                                            Abrams, J Brian                  Miller, Gerald O
  1314 Redwood Rd Ste 102                                                   (435) 752-9662                                                   217 S 100 W
  (801) 768-0440                          1451 N 200 E Ste 200              Workman, Cameron M              942 E North Union Ave Ste A108
                                          (435) 753-4400                                                    (801) 562-2147                   (435) 587-2528
  Hendrickson, R Heath                    Betz, W Philip
                                                                            150 E 200 N Ste B2
                                                                                                            FOREIGN LANGUAGE(S):             FOREIGN LANGUAGE(S):
  1314 Redwood Rd Ste 102                                                   (435) 752-9225                                                   Spanish
  (801) 768-0440                          1260 N 200 E Ste 9                                                Spanish
  Latham, David B
                                          (435) 752-9311
                                                                                Oral Surgeon                Berg, Gerald R
  181 N 1200 E
                                          Bingham, Legrand                                                  7001 S 900 E Ste 450                Monument
                                          120 W Cache Valley Blvd Ste 200   Anderson, Gregory E             (801) 561-0061
  (801) 766-3600
                                          (435) 753-7563                    1395 N 400 E Ste B              Blackhurst, Ronald J                 Valley
  Lloyd, Mv Sheffield                     Binns, Ralph                      (435) 755-5000                  7001 S 900 E Ste 450
  3300 Running Creek Way Ste                                                Jessen, G Shane                 (801) 561-5212
  D100                                    150 E 200 N Ste F
                                                                            1230 N 200 E
                                                                                                                                                General Dentist
  (801) 766-4444                          (435) 753-1686                                                    Bowen, Ronald S
                                          Blanch, Joseph P                  (435) 750-5082                  954 E North Union Ave Ste B101   Dehart, Craig
  Losee, Blair I                                                            FOREIGN LANGUAGE(S):            (801) 565-8080                   30 W Medical Dr PO Box 360005
  3098 Executive Pkwy Ste 250             167 E 200 N Ste 6
                                          (435) 752-2704                    Spanish                         Curtis, Raymond J                (435) 727-3000
  (801) 766-5300
                                          Carter, Justin                    Wilkinson, Stuart D             6770 S 900 E Ste 301             Vreeken, Joseph
  McInnes, Matthew                                                          1320 N 600 E Ste 3              (801) 568-1600                   30 W Medical Dr PO Box 360005
  1314 Redwood Rd Ste 102                 1451 N 200 E Ste 200
                                          (435) 753-4400                    (435) 752-5681                  Gardner, Timothy A               (435) 727-3000
  (801) 768-0440
  Myers, John W                           Chudleigh, Brian                                                  7001 S 900 E Ste 130
  1314 N Redwood Rd 102                   550 E 1400 N Ste E                          Magna                 (801) 255-4421                          Morgan
  (801) 768-0440                          (435) 752-4850                                                    Lundberg, Brent Dee
  Ostheller, Joseph                       Crowther, Glade R                                                 684 W Center St
  1530 N State St Unit A                  1515 N 400 E Ste 104                 General Dentist              (801) 255-4953                      General Dentist
  (801) 770-2836                          (435) 755-6061
                                                                            Cantwell, Nicholas              Marz, Kenneth J                  Crowther, Lance D
  Petersen, Hans C                        Ellis, Jeremy W                   8370 W 3500 S                   918 Fort Union Blvd              195 E 100 N
                                          965 S 100 W Ste 102               (801) 250-0203                  (801) 304-9391                   (801) 829-6471
  216 E Main St Ste 3
  (801) 766-5557                          (435) 752-9741
                                                                            Haynie, Michael                 Morgan, Jaimee A                 FOREIGN LANGUAGE(S):
  Rush, Ryan K                            Gordon, David R                   8031 W 3500 S                   204 E Ft Union Blvd Ste 102      Spanish
                                          981 S Main St Ste 260             (801) 250-0668                  (801) 561-9999                   Crowther, Theran
  1314 Redwood Rd Ste 102
  (801) 768-0440                          (435) 787-0222                    FOREIGN LANGUAGE(S):            Olson, Craige J                  195 E 100 N
  Snow, Harold                            Gunnell, Lance F                  Spanish/Samoan                  7495 S State St                  (801) 829-6471
                                          1320 N 600 E Ste 2                                                (801) 213-9530                   Hopkin, Joe T
  1530 N State St Unit A                                                    Johnson, Lynn S
  (801) 770-2836                          (435) 752-1747
                                                                            3564 S 7200 W Ste B             Packer, Barlow L                 5923 W Old Hwy Rd
  Tayler, Brandon                         Hammond, Keith D                  (801) 250-1717                  1275 E Ft Union Blvd Ste 210     (801) 876-3845
                                          290 N 200 E                                                       (801) 566-5959                   Hopkins, Jess C
  325 E 100 N                                                               Sorensen, Eric J
  (801) 768-9471                          (435) 753-0505
                                                                            3665 S 8400 W Ste 250           Packer, McKay B                  209 N State St Ste A
                                          FOREIGN LANGUAGE(S):                                              1275 E Ft Union Blvd Ste 210     (801) 845-9090
  Tobler, Bret A                          Spanish
                                                                            (801) 250-0450
                                                                                                            (801) 566-5959
  181 N 1200 E                                                              Sorenson, Terry R
                                          Harris, Frank O                                                   Paredes, Cesar
  (801) 766-3600
  Tobler, Eric A                          193 E 1600 N
                                                                            3665 S 8400 W Ste 250
                                                                            (801) 250-0450                  7321 S State St Ste F                      Moroni
                                          (435) 753-5166                                                    (801) 563-5848
  181 N 1200 E
  (801) 766-3600                          Harris, Paul E                         Orthodontist               Presley, Stanley K                    Orthodontist
  Tobler, Nathan B                        40 W Cache Valley Blvd Ste 2A                                     204 E Ft Union Blvd Ste 102
                                          (435) 787-8207                    Parker, Justin O                (801) 561-9999                   Holman, R Gayle
  181 N 1200 E                                                                                                                               394 E 100 S
  (801) 766-4238                          Jensen, S Wayne                   3564 S 7200 W                   Taylor, Michelle L
                                          167 E 200 N Ste 1                 (801) 262-1500                  7681 S 700 E                     (435) 436-8281
                                          (435) 752-5451                                                    (801) 565-9411                   FOREIGN LANGUAGE(S):
       Oral Surgeon                       Larsen, Elmer G                                                   Wright, Stephen O                Spanish
  Bateman, Adam R                         110 E 200 N                                                       852 Fort Union Blvd
  2961 W Maple Loop Dr Ste 130            (435) 753-3763                                                    (801) 566-3332
  (801) 492-4800



(*) Accepting Established Patients ONLY                                                                                                                    Page 5
                                                             Participating Premier Providers

                                          Myers, John W                                                                              Daines, Clifford
             Mount                        279 E 5900 S Ste 200
                                          (801) 560-0061
                                                                                Nephi                    North Salt                  5974 Fashion Point Dr Ste 230
                                                                                                                                     (801) 621-8440
            Pleasant                      Ormsby, Daniel W                                                 Lake                      Davila, L John
                                          5801 Fashion Blvd Ste 150      General Dentist                                             2507 Madison Ave
                                          (801) 424-9031              Jones, Nelson L                                                (801) 394-9428
      General Dentist                     Patton, Bekki T                                               General Dentist              FOREIGN LANGUAGE(S):
                                                                      310 N 400 E
  Huntington, Nathan S                    292 E 3900 S Ste 7          (435) 623-1918                 Demille, Christopher            Spanish
  1055 S Medical Dr                       (801) 747-8018              FOREIGN LANGUAGE(S):           386 N Redwood Rd Ste 106        Day, John W
  (435) 462-3800                          Rosander, Kris H            German                         (801) 969-3025                  5738 S 1475 E Ste 200
  FOREIGN LANGUAGE(S):                    292 E 3900 S Ste 7                                         FOREIGN LANGUAGE(S):            (801) 479-3500
  Spanish                                                             Petersen, Douglas A            Spanish
                                          (801) 262-0807              310 N 400 E                                                    Dickerson, Darin
  Olson, Glen S                           Slater, Rodney J            (435) 623-1918                 Mackay, David C                 5974 Fashion Point Dr Ste 210
  535 W Horseshoe Mountain Ln             678 E Vine St Ste 12        Petersen, Scott W              386 N Redwood Rd Ste 106        (801) 475-6121
  (435) 462-2070                          (801) 268-1135              310 N 400 E                    (801) 969-3025                  Draper, Mary F
                                          Smith, Andrew M             (435) 623-1916                 Mackay, Lyndon                  1508 E Skyline Dr Ste 400
             Murray                       6040 Fashion Blvd Ste 100
                                          (801) 262-6661
                                                                      Rush, Ryan K                   386 N Redwood Rd Ste 106
                                                                                                     (801) 969-3025
                                                                                                                                     (801) 475-6500
                                                                                                                                     Eliason, G M
                                                                      1007 N Main St
                                          Torgeson, Gerald L          (435) 623-0866                                                 3955 Harrison Blvd
            Endodontist                   164 E 5900 S Ste A111       Weber, John P                            Ogden                 (801) 393-7781
  Madsen, Randall                         (801) 262-1181              1007 N Main St                                                 Ellis, James W
  6095 S Fashion Pl Blvd Ste 290          Updike, Spencer T           (435) 623-0866                                                 1220 33rd St Ste C
  (801) 262-2983                          292 E 3900 S Ste 7                                              Endodontist                (801) 394-4519
                                          (801) 747-8015                                                                             Favero, Jeffrey K
  Wayment, Nathan S
  445 E 4500 S Ste 150                    Vernon, Andrew M             North Logan                   Cox, Val S
                                                                                                     3590 Harrison Blvd Ste 4        3500 Harrison Blvd Ste 104
  (801) 288-0039                          715 E 3900 S Ste 211                                       (801) 393-9616                  (801) 621-4943
                                          (801) 263-0417                 General Dentist             Karren, Gary R                  Ford, Jonathan G
      General Dentist                     Wright, Jay W                                              5974 Fashion Point Dr Ste 210   1508 E Skyline Dr Ste 400
                                          140 E 4800 S                Carlson, Monte L               (801) 475-6121                  (801) 475-6500
  Baggaley, Todd J                        (801) 266-7351              3125 N Main St Ste 104
                                                                                                     Watts, Robert K                 FOREIGN LANGUAGE(S):
  292 E 3900 S Ste 7                                                  (435) 787-4444                                                 Spanish
                                                                      Cole, Daren C                  5974 Fashion Point Dr Ste 210
  (801) 747-8000                               Oral Surgeon                                          (801) 475-6121                  Garr, Benjamin L
  Blackhurst, David R                     Roberts, Greg A
                                                                      1515 N 400 E Ste 104                                           1186 E 4600 S Ste 410
  445 E 4500 S Ste 150                                                (435) 755-6061                                                 (801) 334-9444
  (801) 288-0039                          622 E 4500 S Ste 202        Porter, Bryan D                   General Dentist              FOREIGN LANGUAGE(S):
                                          (801) 266-3578
  FOREIGN LANGUAGE(S):
                                          Smoot, David J
                                                                      3125 N Main St Ste 104         Adams, Delos C                  Spanish
  Portuguese/Spanish/Vietnamese                                       (435) 787-4444                 3915 Ogden Ave
                                          6095 Fashion Blvd Ste 120                                                                  Geddes, Derald W
  Blanco, David                           (801) 264-8504
                                                                                                     (801) 392-1000                  1220 33rd St Ste D
  4370 S Redwood Rd                                                        Periodontist              Allen, Owen C                   (801) 546-9400
  (801) 969-1802                                                      Maughan, Willard W             5685 S 1475 E Ste 2A            Geddes, Mark C
  FOREIGN LANGUAGE(S):                         Orthodontist                                          (801) 475-0509                  1220 33rd St Ste B
                                                                      1445 N 400 E
  Spanish                                 Baugh, Alan C               (801) 786-9009                 FOREIGN LANGUAGE(S):            (801) 394-4415
  Boren, Don R                            164 E 5900 S A-109                                         Portuguese                      Gilbert, J Bryan
  678 E Vine St Ste 12                    (801) 266-0061                                             Austad, Thomas N
  (801) 268-1135                          Carter, Gary A               North Ogden                   5974 Fashion Point Dr Ste 210
                                                                                                                                     5685 S 1475 E Ste 1-A
                                                                                                                                     (801) 476-7299
  Briggs, Graydon J                       6052 S State St Ste 7                                      (801) 475-6121                  FOREIGN LANGUAGE(S):
  5292 College Dr Ste 102                 (801) 288-9100                   Endodontist               Barclay, James J                German
  (801) 707-3424                          Parker, Justin O                                           2201 N 400 E                    Handy, Ken B
  Carter, Stephen W                       586 W 5300 S Ste 101        Wayment, Nathan S              (801) 782-6681                  3500 Harrison Blvd Ste 104
  545 E 4500 S Ste E200                   (801) 262-1500              2274 N 400 E Ste 202           FOREIGN LANGUAGE(S):            (801) 621-4943
  (801) 261-2273                          Young, David V              (801) 782-8300                 Portuguese/Spanish              Hansen, Heather D
  FOREIGN LANGUAGE(S):                    622 E 4500 S Ste 202                                       Blamires, Michael A             2201 N 400 E
  Spanish                                 (801) 266-3578                 General Dentist             5974 Fashion Point Dr Ste 210   (801) 782-6681
  Christensen, Kurt D                                                 Cottle, Douglas G              (801) 475-6121                  Haslam, Jeffrey R
  678 E Vine St Ste 12                           Pediatrics           2274 N 400 E Ste 204           Booth, Gregory A                448 E 5350 S Ste C
  (801) 268-1135                                                      (801) 399-0458                 1245 Capitol St Ste 101S        (801) 479-1700
                                          Anderson, Eric S
  Daynes, Scott P                         292 E 3900 S Ste 7          Garner, L Ray                  (801) 621-5910                  Healy, James R
  463 Murray Blvd                         (801) 262-0807              365 E Lomond View Dr Ste 201   Booth, Paul                     548 12th St
  (801) 268-2323                                                      (801) 782-9269                 1245 Capitol St Ste 101         (801) 394-0808
                                          Burg, Jeffrey S
  Goodman, Chris E                        678 E Vine St Ste 12        FOREIGN LANGUAGE(S):           (801) 621-5910                  Hicken, Clark
  6095 Fashion Blvd Ste 290               (801) 268-1135              Spanish                        Burdett, Daniel S               5974 Fashion Point Dr Ste 210
  (801) 262-7770                                                      Greenhalgh, Jon                5331 S 500 E Ste C              (801) 475-6121
                                          Knudson, Darin
  Hadfield, Benjamin                      678 E Vine St Ste 12        2201 N 400 E                   (801) 475-0680                  Iverson, Clint
  292 E 3900 S Ste 7                      (801) 268-1135              (801) 782-6681                 Butterfield, Brad A             1770 Combe Rd Ste 2
  (801) 747-8015                                                      Harris, Mark E                 1761 N 2000 W                   (801) 475-1999
                                          Segura, Stuart D
  Hodge, Jason                            678 E Vine St Ste 12        2274 N 400 E Ste 204           (801) 731-9058                  FOREIGN LANGUAGE(S):
  5642 S 900 E Ste 6                      (801) 268-1135              (801) 399-0458                 Call, Nathan D                  Spanish
  (801) 261-2202                                                      Swenson, Michael D             4590 Harrison Blvd Ste 100B     Johnson, Robert
  Loftus, David O                              Periodontist           2274 N 400 E Ste 201           (801) 392-5637                  5974 Fashion Point Dr Ste 210
  865 E 4800 S                                                        (801) 782-7913                 Chidester, Robert J             (801) 475-6121
  (801) 262-7427                          Maughan, Willard W                                         5974 Fashion Point Dr Ste 210   Johnson, Robert H
  Magleby, Bruce L                        292 E 3900 S Ste 7                    Pediatrics           (801) 475-6121                  6017 Fashion Point Dr
  4010 S 700 E Ste 6                      (801) 747-8018                                             Child, Paul                     (801) 475-5155
  (801) 265-1515                                                      Simkins, Boyd                  3785 Harrison Blvd Ste 1        Kelley, Randall J
                                                                      2667 N 400 E
  McGowan, David J
  154 Myrtle Ave Ste 203
                                                Navajo                (801) 782-3920
                                                                                                     (801) 621-2116
                                                                                                     Collman, Marc
                                                                                                                                     5738 S 1475 E Ste 200
                                                                                                                                     (801) 479-3500
  (801) 590-8786                               Mountain                                              2251 N 400 E                    Knight, Samuel D
  Middleton, John H                                                                                  (801) 782-9544                  1761 N 2000 W
  4800 S 140 E
                                             General Dentist                                         Craven, Scott H                 (801) 731-3200
  (801) 266-7351                                                                                     2201 N 400 E                    Knudson, Darin R
  FOREIGN LANGUAGE(S):                    Vreeken, Joseph                                            (801) 782-6681                  1920 W 250 N Ste 3
  Italian                                 Ste 2 Rainbow Rd                                           Crowton, Michael L              (801) 731-4848
  Miller, Mark T                          (928) 672-2494                                             448 E 5350 S Ste A              Lindgren, Jeremiah M
  715 E 3900 S Ste 211                                                                               (801) 479-7870                  5974 Fashion Point Dr Ste 210
  (801) 263-0417                                                                                     Curtis, Lindsay S               (801) 475-6121
                                                                                                     5640 Wasatch Dr Ste A
                                                                                                     (801) 479-6590



(*) Accepting Established Patients ONLY                                                                                                            Page 6
                                                           Participating Premier Providers

                                          Roberson, Jeffrey               Jessen, G Shane                 Brown, Garry M                  Maughan Jr, Kenneth C
            Ogden                         5974 Fashion Point Dr Ste 210
                                          (801) 475-6121
                                                                          1508 E Skyline Dr Ste 800
                                                                          (801) 479-8200
                                                                                                          320 E 800 S
                                                                                                          (801) 224-9555
                                                                                                                                          167 N 400 W Ste A4
                                                                                                                                          (801) 226-3302
           (Cont'd)                       Russell, Michael A              FOREIGN LANGUAGE(S):            Cerny, William                  FOREIGN LANGUAGE(S):
                                          2240 N Highway 89               Spanish                         1834 S State St                 Japanese
     General Dentist                      (801) 782-4745                  Liston, Todd C                  (801) 224-0222                  McInnes, Matthew
                                          Saunders, Darrell J             3590 Harrison Blvd Ste 2        FOREIGN LANGUAGE(S):            503 E 770 N
        (Cont'd)                          165 N Harrison Blvd             (801) 299-8531                  Spanish                         (801) 225-1400
                                          (801) 394-9488                  Roberts, Greg A                 Chidester, Robert J             Meek, Daniel
  Linsley, Kent                           Saunders, Richard D             5742 S 1475 E Ste 100           575 E University Pkwy Ste A24   575 E University Pkwy Ste A24
  2201 N 400 E                            165 N Harrison Blvd             (801) 479-9070                  (801) 225-3300                  (801) 764-9069
  (801) 782-6681                          (801) 394-9488                                                  Christiansen, Craig A           Molen, Kenneth
  Mackley, Mark D                         Saunders, Ryan                       Orthodontist               476 W 800 N                     1176 S 1480 W
  2201 N 400 E                            165 N Harrison Blvd                                             (801) 221-7615                  (801) 426-8234
  (801) 782-6681                          (801) 394-9488                  Allred, Kirk H                  Crawford, J Chris               Morrison, Jeffrey S
                                                                          3550 Harrison Blvd Ste 2
  Mackley, Paul                           Shaw, Tyler                     (801) 393-6200                  265 W Center St                 344 W 920 N
  2201 N 400 E                            1245 Capitol St Ste 111-5                                       (801) 225-5888                  (801) 225-2640
  (801) 782-6681                          (801) 394-1289                  Baird, Brian W                  Dickerson, Darin                Myers, John W
                                                                          5974 Fashion Point Dr Ste 210
  Malan, Matthew                          Shurtleff, William J            (801) 475-6121                  575 E University Pkwy A-24      503 E 770 N
  3860 Jackson Ave Ste 4                  5300 S 500 E Ste 14                                             (801) 225-3300                  (801) 225-1400
  (801) 627-0410                          (801) 476-9000                  Fisher, William C               Dowling, Ryan S                 Olsen, Phillip
                                                                          5974 Fashion Point Dr Ste 210
  Malan, Max J                            Smith, Gregory                  (801) 475-6121                  575 E University Pkwy Ste A24   575 E University Pkwy Ste A24
  3860 Jackson Ave                        5974 Fashion Point Dr Ste 210                                   (801) 225-3300                  (801) 764-9069
  (801) 627-0410                          (801) 475-6121                  Shaw, Jerry L                   Downing, Randy N                Park, Kwang
                                                                          1761 N 2000 W
  McConkie, Daniel                        Starley, John R                 (801) 731-4850                  503 E 770 N                     1834 S State St
  539 N Harrisville Rd                    3590 Harrison Blvd Ste 6                                        (801) 225-1400                  (801) 224-0222
  (801) 528-9573                          (801) 621-3553                                                  Eldredge, Stephen               FOREIGN LANGUAGE(S):
  McGarry, Cody G                         Starley, Nathan J                         Pediatrics            1834 S State St                 Korean
  5640 Wasatch Dr Ste A                   3590 Harrison Blvd Ste 6        Christensen, Aaron A            (801) 224-0222                  Payne, Glenn R
  (801) 479-6590                          (801) 621-3553                  3550 Harrison Blvd Ste 1        Faerber, David E                440 W 800 N
  Meeks, Daniel                           Steele, Richard H               (801) 627-1221                  503 E 770 N                     (801) 764-9444
  5974 Fashion Point Dr Ste 210           5974 Fashion Point Dr Ste 210   Christensen, Allen M            (801) 225-1400                  Peacock, Steven L
  (801) 475-6121                          (801) 475-6121                  3550 Harrison Blvd Ste 1        Fisher, William C               1344 S 800 E
  Menlove, Benjamin                       Suisse, Brent                   (801) 627-1221                  575 E University Pkwy A-24      (801) 224-6165
  5974 Fashion Point Dr Ste 210           2201 N 400 E                    Rallison, M W                   (801) 764-9069                  Pincock, David W
  (801) 475-6121                          (801) 782-6681                  5275 S 500 E Ste C              Frandsen, Brian L               1694 N State St
  Merrill, David R                        FOREIGN LANGUAGE(S):            (801) 475-6433                  165 S Orem Blvd                 (801) 762-0100
  3795 Kiesel Ave Ste 3                   Spanish                                                         (801) 224-7900                  Prince, David B
  (801) 399-1330                          Talbot, Bryon J                      Periodontist               Green, John                     417 N Orem Blvd
  Miller, Matthew                         5640 Wasatch Dr Ste Bbb         Chaston, Reve                   1256 S State St Ste 103         (801) 222-0789
  5742 S 1475 E Ste 100                   (801) 479-4830                                                  (801) 224-7182                  FOREIGN LANGUAGE(S):
  (801) 392-2182                                                          5974 Fashion Point Dr Ste 210
                                          FOREIGN LANGUAGE(S):
                                                                          (801) 475-6121                  Hart, Brody James               Spanish
  Moyes, Brett K                          Spanish
                                                                          Maughan, Willard W              517 E 770 N                     Reading, Tyler
  1770 Combe Rd Ste 2                     Tobias, Justin S                2717 N Highway 89 Ste 200
                                                                                                          (801) 225-1400                  575 E University Pkwy Ste A24
  (801) 475-1999                          1920 W 250 N Ste 3                                              Hendrickson, R Heath            (801) 225-3300
                                                                          (801) 786-9009
  Moyes, Laurence K                       (801) 731-4244                                                  503 E 770 N                     Reschke, John
  2783 Madison Ave                        Torghele, Jeffrey J                                             (801) 225-1400                  575 E University Pkwy Ste A24
  (801) 393-5601                          1245 Capitol St Ste 112N                   Orem                 Hicken, Clark B                 (801) 764-9069
  Mund, Kody C                            (801) 621-2702                                                  575 E University Pkwy Ste A24   Roberson, Jeffrey
  3785 Harrison Blvd Ste 1                Tribe, Michael L                     Endodontist                (801) 255-3300                  575 E University Pkwy Ste A24
  (801) 621-2116                          1770 Combe Rd Ste 1                                             Hill, Jared D                   (801) 764-9069
  Nichols, Mark A                         (801) 475-4700                  Watts, Robert K                 205 N State St                  Roberts, Kim G
  450 39th St                             Wayment, David K                575 E University Pkwy Ste A24   (801) 225-7110                  575 E University Pkwy Ste A24
  (801) 621-4421                          450 39th St                     (801) 225-3300                  Hill, Jerel D                   (801) 225-3300
  Nilson, Scott B                         (801) 621-4422                                                  205 N State St                  Rogers, Robert C
  1508 E Skyline Dr Ste 500               FOREIGN LANGUAGE(S):               General Dentist              (801) 225-7110                  201 N State St
  (801) 393-4512                          Spanish                                                         Hills, P Bradley                (801) 225-7712
                                                                          Arthur, David K
  Norris, Kipton J                        West, E Judd                    169 W 800 N                     560 S State St Ste K2           Rush, Ryan K
  5990 Fashion Point Dr Ste 2             3860 Jackson Ave Ste 6          (801) 224-1997                  (801) 610-5000                  503 E 770 N
  (801) 475-4288                          (801) 627-0420                                                  Hoyal, James C                  (801) 225-1400
                                                                          Arthur, Douglas K
  Oliverson, Sean M                       Winder, George                  169 W 800 N                     1802 N State St                 Sachs, Steven
  3550 Harrison Blvd Ste 2                5974 Fashion Point Dr Ste 210   (801) 224-1997                  (801) 224-0320                  1442 E 820 N
  (801) 393-6200                          (801) 475-6121                                                  Hudson, Sascha                  (801) 225-4701
                                                                          Austad, Thomas N
  Olsen, Phillip                          Wolthuis, Jared                 575 E University Pkwy Ste A24   1834 S State St                 Scott, Kyle S
  5974 Fashion Point Dr Ste 210           512 12th St                     (801) 764-9069                  (801) 224-0222                  167 N 400 W
  (801) 475-6121                          (801) 399-5831                                                  Johnson, Robert H               (801) 225-1002
                                                                          Ball, Douglas
  Palmer, Brian S                         Wright, Aaron D                 1344 S 800 E Ste 220            575 E University Pkwy Ste A24   Smith, Gregory
  2201 N 400 E                            5974 Fashion Point Dr Ste 210   (801) 224-6165                  (801) 225-3300                  575 E University Pkwy Ste A24
  (801) 782-6681                          (801) 475-6121                                                  Larsen, Alexander B             (801) 764-9069
                                                                          Barry, David J
  Palmer, Laurence R                      Zapata, Jorge F                 165 N 400 W Ste 2A              385 W Center St                 Steele, Richard H
  1245 Capitol St Ste 106-S               859 Washington Blvd Ste 2       (801) 226-0441                  (801) 224-1117                  575 E University Pkwy Ste A24
  (801) 394-0401                          (801) 394-5240                                                  Lee, Jung                       (801) 225-3300
  FOREIGN LANGUAGE(S):                                                    Barry, Mark T
                                          FOREIGN LANGUAGE(S):            165 N 400 W Ste A2              165 N 400 W Ste A2              Swenson, Damon P
  French                                  Spanish                         (801) 226-0441                  (801) 226-0441                  1643 N State St
  Petty, Richard O                                                        Black, W Michael                Lindgren, Jeremiah M            (801) 224-7337
  448 E 5350 S Ste A                           Oral Surgeon               1375 E 800 N Ste 103            575 E University Pkwy A-24      Taylor, Robert R
  (801) 479-7870                                                          (801) 225-2310                  (801) 764-9069                  1692 N State St
  Rasmussen, Rochelle                     Broadbent, Michael W                                            Loeser, Michael                 (801) 226-6611
                                          3590 Harrison Blvd Ste 2        Blackhurst, David R
  5738 S 1475 E Ste 200
                                          (801) 779-0506                  517 E 770 N                     1834 S State St                 Walker, Bradley S
  (801) 479-3500                                                          (801) 225-1400                  (801) 224-0222                  1834 S State St
                                          FOREIGN LANGUAGE(S):
  Reading, Tyler                          Portuguese                      Blume, Dennis J                 FOREIGN LANGUAGE(S):            (801) 224-0222
  5974 Fashion Point Dr Ste 210                                           1802 N State St                 Spanish                         FOREIGN LANGUAGE(S):
  (801) 475-6121                          Chandler, Jason G               (801) 224-0320                  Madsen, Dennis R                Spanish
  Reschke, John                           3590 Harrison Blvd Ste 2
                                          (801) 392-7176                  Braithwaite, Randy C            201 N State St                  White, Jeremy
  597 S Fashion Pointe Dr Ste 210                                         503 E 770 N                     (801) 224-5220                  594 E 800 S Ste G
  (801) 475-6121                          FOREIGN LANGUAGE(S):
                                                                          (801) 225-1400                                                  (801) 765-1443
                                          Spanish



(*) Accepting Established Patients ONLY                                                                                                                 Page 7
                                                           Participating Premier Providers

                                          Rupp, Jeffery K                    Blackhurst, David                                             Rush, Ryan K
  Orem (Cont'd)                           575 E University Pkwy Ste A24
                                          (801) 225-3300
                                                                             78 E 100 S
                                                                             (801) 465-0550
                                                                                                                  Perry                    465 E 1000 S
                                                                                                                                           (801) 785-6000
                                                                             Braithwaite, Randy C                                          Smith, G Trevor
     General Dentist                           Periodontist                  78 E 100 S                    General Dentist                 60 E State Rd
        (Cont'd)                          Rizzo, Richard J
                                                                             (801) 465-0550             Jenson, Richard H                  (801) 785-2574
                                          575 E University Pkwy Ste A24      Cahoon, Kevin S            117 W Forest St
  Winder, George                          (801) 225-3300                     107 S 500 W                (435) 723-8136                          Oral Surgeon
  575 E University Pkwy Ste A24                                              (801) 465-7966
                                                                             FOREIGN LANGUAGE(S):                                          Crawford, Gary L
  (801) 764-9069
  Wright, Aaron D                             Panguitch                      Spanish                         Pleasant                      912 N 2000 W
                                                                                                                                           (801) 756-0766
  575 E University Pkwy A-24                                                 Callister, J Craig
                                                                             1172 E 100 N Ste 6
                                                                                                              Grove                        FOREIGN LANGUAGE(S):
  (801) 225-3300                               Orthodontist                  (801) 465-3691
                                                                                                                                           Spanish
  Young, Christopher                                                                                                                       McBee, William L
  1834 S State St                         Oldroyd, Roger J                   Callister, John D             General Dentist                 912 N 2000 W
  (801) 224-0222                          75 N 200 E                         1172 E 100 N Ste 6
                                          (435) 835-4881                     (801) 465-3691
                                                                                                        Adamson, William F                 (801) 756-0766
  FOREIGN LANGUAGE(S):                                                                                  233 S Pleasant Grove Blvd Ste
  Spanish                                 FOREIGN LANGUAGE(S):               Downing, Randy N           204
  Young, Michael W                        Spanish                            78 E 100 S                 (801) 785-2821                          Pleasant
                                                                             (801) 465-0550
  1834 S State St
  (801) 224-0222                               Park City                     Faerber, David E
                                                                                                        Blackhurst, David R
                                                                                                        922 N 2000 W
                                                                                                                                                  View
  Young, Nicolas K                                                           78 E 100 S                 (801) 763-5555
  165 N 400 W Ste 2A                                                         (801) 465-0550             FOREIGN LANGUAGE(S):                  General Dentist
  (801) 226-0441                               Endodontist                   Farley, John M             Portuguese
                                                                             805 S 500 W                                                   Hesselgesser, Lamont E
  Youngquist, Jeffrey                     Flath, Robert K                                               Blackhurst, Robert R               2703 Parkland Blvd
  845 N 100 W Ste 100                                                        (801) 465-3256             922 N 2000 W
                                          2750 Rasmussen Rd Ste 102                                                                        (801) 737-4650
  (801) 227-5080                          (435) 645-7668                     Gunnerson, K Cheyn         (801) 763-5555
                                                                             33 W 300 S                 FOREIGN LANGUAGE(S):
                                                                                                                                           Hopkins, Paul D
                                                                             (801) 465-3233                                                859 W Pleasant View Dr
       Oral Surgeon                          General Dentist                                            Spanish                            (801) 737-4477
                                                                             Hart, Brody James          Blake, Heath J
  Burton, Christopher                     Abraham II, James G                78 E 100 S                                                    Neeley, J. Christian
                                                                                                        198 S Main St                      2717 N Highway 89 Ste 100
  480 W 800 N                             1526 Ute Blvd Ste 212              (801) 465-0550             (801) 785-8308
  (801) 224-1200                          (435) 615-8500                                                                                   (801) 737-2410
                                                                             Hendrickson, R Heath       Braithwaite, Randy C
  FOREIGN LANGUAGE(S):                    Coleman, Jonathan F                78 E 100 S                                                    Scoville, R Kent
  Spanish                                                                                               465 E 1000 S                       2685 N 1000 W Ste 101
                                          1441 Ute Blvd Ste 200              (801) 465-0550             (801) 785-6000
  Israelsen, L Douglas                    (435) 604-0887                                                                                   (801) 737-9442
                                                                             Johnson, Nathan            Colton, Brigham
  1375 E 800 N Ste 103                    Condie, Brian A                    1392 Turf Farm Way Ste 1                                      Scoville, Ronald J
  (801) 397-2727                                                                                        465 E 1000 S                       2685 N 1000 W Ste 101
                                          1729 Sidewinder Dr Ste 102         (801) 465-4490             (801) 785-6000
  Nicholls, David W                       (435) 649-9492                                                                                   (801) 737-9442
                                                                             Mattinson, Keith S         Daynes, David R
  480 W 800 N                             Griffeth, Matthew M                1172 E 100 N Ste 3         30 S Main St
  (801) 224-1200
  FOREIGN LANGUAGE(S):
                                          1680 Ute Blvd Ste C
                                          (435) 647-3012
                                                                             (801) 465-5000             (801) 785-5383                               Price
                                                                             McInnes, Matthew           FOREIGN LANGUAGE(S):
  Spanish                                 Jindal, Harini                     78 E 100 S                 German                                  Endodontist
                                          1729 Sidewinder Dr Ste 102         (801) 465-0550
       Orthodontist                       (435) 649-9492                                                Downing, Randy N
                                                                             Myers, John W              465 E 1000 S                       Sonntag, Keith
  Berg, Christopher                       Kolon, Jonathan                    78 E 100 S                 (801) 785-6000                     95 S 100 E
                                          6415 Business Park Loop Rd Ste J   (801) 465-0550                                                (435) 637-4545
  1375 E 800 N Ste 102                    (435) 658-0032                                                Faerber, David E
  (801) 224-5058                                                             Rush, Ryan K               465 E 1000 S
  Carter, Gary A                          Peterson, John                     110 S 100 W                (801) 785-6000                        General Dentist
                                          1729 Sidewinder Dr Ste 102         (801) 465-4855
  240 E University Pkwy                   (435) 649-9492                                                Hart, Brody James                  Bailey, James I
  (801) 227-0600                                                             Warren, Mark B             465 E 1000 S                       230 N Cedar Hills Dr
  Fenton, Andrew R                        Slater, Rodney J                   822 Highway 198 Ste B      (801) 785-6000                     (435) 637-3186
                                          1901 Prospector Ave Ste 26         (801) 465-1390
  575 E University Pkwy Ste A24           (435) 649-5018                                                Hendrickson, R Heath               Bailey, Ryan H
  (801) 225-3300                                                             Weber, John P              465 E 1000 S                       230 N Cedar Hills Dr
  Jesperson, Jared C                                                         110 S 100 W                (801) 785-6000                     (435) 637-3186
  196 W Center St Ste A
                                                    Pediatrics               (801) 465-4855
                                                                                                        Isaacson, Brian E                  Feller, Paul
  (801) 221-9482                          Baggaley, Todd J                                              4565 W Cedar Hills Dr              250 N Fairgrounds Rd Ste 4
  Jorgensen, Norman G                     1830 Prospector Ave                    Oral Surgeon           (801) 756-9154                     (435) 637-4660
  560 S State St Ste M1                   (435) 649-5001                     Harris, Michael D          Isaacson, Wm Edward                Fonnesbeck, Vance B
  (801) 225-7002                          Burg, Jeffrey S                    1107 S Highway 198         4565 W Cedar Hills Dr              590 E 100 N Ste 3
  Nord, Scott C                           1901 Prospector Ave Ste 26         (801) 356-2226             (801) 756-9154                     (435) 637-5850
  291 E University Pkwy                   (435) 649-5001                     Park, David A              Jackson, Jonathan D                Jackson, M Blane
  (801) 225-7141                          Knudson, Darin R                   1107 S Highway 198         238 E State Rd Ste 2               690 W Price River Dr
  Randle, Brian                           1901 Prospector Ave                (801) 356-2226             (801) 796-7779                     (435) 637-2100
  196 W Center St Ste A                   (435) 649-5001                                                Jolley, Chris M                    Larsen, Clyde S
  (801) 221-9482                          Segura, Stuart D                        Orthodontist          352 E State Rd                     190 N Carbon Ave
  Thompson, Wade D                        1901 Prospector Ave Ste 26                                    (801) 225-2641                     (435) 637-0795
  380 W Center St                         (435) 649-5001                     Lee, Adam N                FOREIGN LANGUAGE(S):
                                                                             814 S Main St                                                 Lowe, Bret K
  (801) 375-7088                                                                                        Spanish                            945 W Hospital Dr Ste 5
                                                                             (801) 465-1118
  FOREIGN LANGUAGE(S):
  Spanish
                                               Parowan                       Trapnell, Christopher J    Jones, Aaron H
                                                                                                        597 S Pleasant Grove Blvd Ste 12
                                                                                                                                           (435) 637-2929
                                                                                                                                           Martinez, Paul B
                                                                             1107 S Highway 198         (801) 796-3535
                                                                             (801) 798-8343                                                95 S 100 E
            Pediatrics                       General Dentist                 Trapnell, Gregory J
                                                                                                        FOREIGN LANGUAGE(S):               (435) 637-4545
                                          Marsh, Justin S                                               Spanish                            Olson, Mark A
  Howell, Bruce                                                              1107 S Highway 198
  442 W 800 N                             14 Main St                         (801) 465-2541             Jones, Ammon                       96 N 400 E
  (801) 802-7200                          (435) 477-9577                                                597 S Pleasant Grove Blvd Ste 12   (435) 637-3236
                                                                                                        (801) 796-3535                     Stilson, Evan A
  Martin, Eric E                                                                       Pediatrics       McIff, Steven F                    250 N Fairgrounds Rd Ste A
  845 N 100 W Ste 100
  (801) 227-5080
                                                    Payson                   Chamberlain, Darren D      31 W 100 S Ste C                   (435) 637-0424
                                                                             805 S 500 W Ste 4          (801) 785-0083
  Mauseth, Spencer
  845 N 100 W Ste 100                        General Dentist                 (801) 465-8300             McInnes, Matthew                        Oral Surgeon
  (801) 227-5080                                                             Evershed, Morgan P         465 E 1000 S
                                                                                                                                           Crawford, Gary L
                                          Baird, Robert M                    805 S 500 W Ste 4          (801) 785-6000
  Robins, Merien L                        1392 W Farm Turf Way Ste 1         (801) 465-8300                                                391 N 400 E
  845 N 100 W Ste 100                                                                                   Myers, John W                      (435) 637-9590
                                          (801) 492-9207                                                465 E 1000 S
  (801) 227-5080                          FOREIGN LANGUAGE(S):                                                                             FOREIGN LANGUAGE(S):
                                                                                                        (801) 785-6000
                                          Vietnamese                                                                                       Spanish


(*) Accepting Established Patients ONLY                                                                                                                  Page 8
                                                           Participating Premier Providers

                                          Brinkerhoff, Matthew S           Nielsen, Paul A                 Ririe, Craig M                  Brown, Wayne D
  Price (Cont'd)                          2520 N University Ave Ste 101
                                          (801) 426-6255
                                                                           1355 N University Ave Ste 330
                                                                           (801) 373-3150
                                                                                                           3610 N University Ave Ste 150
                                                                                                           (801) 356-2226
                                                                                                                                           2332 W 12600 S Ste A
                                                                                                                                           (801) 253-4547
                                          Call, Devon R                    Packer, Chipman W                                               Christensen, Craig M
       Oral Surgeon                       1234 N 900 E                     1375 N University Ave               Randolph                    12600 S 1345 W PO Box 185
         (Cont'd)                         (801) 854-9140                   (801) 377-4745                                                  (801) 253-1500
                                          Call, R Reed                     Perrero, Jeffrey E                                              Dansie, Dan W
  McBee, William L                        777 N 500 W Ste 202              1355 N University Ave Ste 300      General Dentist              4091 W 12600 S Ste 100
                                          (801) 374-1094                   (801) 373-6928                                                  (801) 253-8633
  391 N 400 E
                                          Clark, Albert B                  Perrero, Tyson M                Groll, Shawn R                  Dowdle, Daniel R
  (435) 637-9590                                                                                           275 N Main St
  Urban, Scott D                          1355 N University Ave Ste 320    1355 N University Ave Ste 300   (435) 793-2210                  4019 W 12600 S Ste 100
  95 S 100 E                              (801) 375-1750                   (801) 373-6928                                                  (801) 253-8633
  (435) 637-4545                          Downing, Randy N                 Pinegar, Steven C                                               Gardner, Jonathan B
                                          1275 N University Ave Ste 7      1021 N University Ave Ste 100        Richfield                  12684 S Redwood Rd
       Orthodontist                       (801) 375-2273                   (801) 373-8221                                                  (801) 446-8446
                                          Erickson, Louis A                Schiffman, Quinn                   General Dentist              Howarth, Joel L
  Broadwater, Paul M                      777 N 500 W Ste 201B             1355 N University Ave Ste 320                                   3409 W 12600 S Ste 100
  391 N 400 E                             (801) 374-5200                   (801) 375-1750                  Christensen, Ted L              (801) 561-1559
  (435) 637-2222                          Flick, Steven K                  Scott, Jay D                    560 N Main St                   Kwant, John W
  Schouten, John R                        1355 N University Ave Ste 310    3330 N University Ave Ste A     (435) 896-8282                  12391 S 4000 W Ste 206
  191 E 100 N                             (801) 373-2693                   (801) 375-1965                  Jeffery, Darrin R               (801) 748-0380
  (435) 637-0820                          Ford, T Michael                  Smith, Ronald T                 325 N 600 E                     Lloyd, Jon W
                                          10 S 300 E                       3651 N 100 E Ste 175            (435) 893-8888                  1291 W 12600 S Ste 101
            Pediatrics                    (801) 375-8770                   (801) 356-3025                  Kunzler, Richard C              (801) 446-1166
  Lund, Trace M                           Gardner, Darren W                FOREIGN LANGUAGE(S):            65 S 100 E                      Maio, Joseph S
  391 N 400 E                             1675 N Freedom Blvd Ste 12A      Spanish                         (435) 896-9393                  12391 S 4000 W Ste 206
  (435) 820-1874                          (801) 374-8970                   Tidwell, Eric I                 Lee, Todd P                     (801) 748-0379
  FOREIGN LANGUAGE(S):                    FOREIGN LANGUAGE(S):             777 N 500 W Ste 101             46 W 100 N                      Myers, John W
  French                                  Korean                           (801) 373-6362                  (435) 893-2190                  6351 W 13400 S
  Markham, Kevin R                        Guenter, R Jeremy                Wagner, Spencer B                                               (801) 302-7808
  391 N 400 E                             835 N 700 E                      2520 N University Ave Ste 101       Oral Surgeon                Nelson, Raechel A
  (435) 637-9590                          (801) 373-7700                   (801) 426-6255                                                  3409 W 12600 S Ste 220
                                                                                                           Dudley, Wayne H
                                          Guenter, Robert J                FOREIGN LANGUAGE(S):
                                                                                                           850 N Main St Ste 1
                                                                                                                                           (801) 542-0267
                                          3707 N Canyon Rd Ste 7D          Spanish                                                         Noh, Bong K
     Providence                           (801) 221-5859                   Weber, John P
                                                                                                           (435) 896-9696
                                                                                                           Mizukawa, John H                2845 W 12600 S
                                          Hamblin, Robert L                777 N 500 W Ste 202             850 N Main St Ste 1
                                                                                                                                           (801) 254-5255
     General Dentist                      3200 N Canyon Rd Ste F           (801) 356-8420                  (435) 896-9696                  Pugh, B Charles
                                          (801) 377-7200                   Wiest, Gary B                                                   12694 S Redwood Rd
  Allen, Stanton C                        Hamilton, Ryan                                                                                   (801) 254-1278
  169 Springcreek Pkwy Ste 200            2335 S State St Ste 200
                                                                           168 W 800 N
                                                                           (801) 374-8205
                                                                                                                Orthodontist               Richey, Samuel
  (435) 787-2223                                                                                           Oldroyd, Roger J
                                          (801) 377-0037                   Wilson, Gary L                                                  3926 Innovation Dr Ste F
  Butler, Todd M                          Hanson, Nathan                   1355 N University Ave Ste 310   490 N Main St                   (801) 446-6310
  274 N Spring Creek Pkwy                 3685 N 100 E Ste B               (801) 370-4040                  (435) 896-4053                  Sorenson, Terry R
  (435) 713-0096                                                                                           FOREIGN LANGUAGE(S):
                                          (801) 356-1211                   Wood, Max S                                                     12569 S 2700 W Ste 100
  Johnson, Richard S                      Harding, Roger K                 1275 N University Ave Ste 11    Spanish                         (801) 254-7272
  169 N Gateway Dr Ste 175                488 N 100 E                      (801) 377-6448                                                  Yeager, Kevin L
  (435) 787-2122
  FOREIGN LANGUAGE(S):
                                          (801) 374-0867
                                          Hendrickson, Heath                   Oral Surgeon
                                                                                                               Richmond                    2364 W 12600 S Ste F
                                                                                                                                           (801) 446-5050
  Spanish                                 2230 N University Pkwy
  Walton, Troy R                          (801) 370-0050                   Crawford, Gary L                   General Dentist                  Oral Surgeon
  271 N Spring Creek Pkwy Ste D                                            777 N 500 W Ste 102
                                          Heward, Timothy                  (801) 375-4707                  Carlson, Monte L                Harris, Michael D
  (435) 755-6562                          275 N 500 W Ste C                FOREIGN LANGUAGE(S):            105 S 200 W                     3409 W 12600 S Ste 120
                                          (801) 374-5768                                                   (435) 258-2301
                                                                           Spanish                                                         (801) 446-4428
            Provo                         Heward, Timothy S                Dobson, Dennis L                FOREIGN LANGUAGE(S):            Park, David A
                                          275 N 500 W Ste C                                                Spanish                         3409 W 12600 S Ste 120
                                          (801) 374-5768                   280 River Park Dr Ste 360
        Endodontist                                                        (801) 437-7701                  Larson, Anthony L               (801) 446-4428
                                          Hillam, R Barry                  Harris, Michael D               105 S 200 W                     Price, Christopher J
  Facer, Steven R                         10 S 300 E                                                       (435) 258-2301                  3409 W 12600 S 120
                                          (801) 375-8770                   3610 N University Ave Ste 150
  3355 N University Ave Ste 100                                            (801) 356-2226                  FOREIGN LANGUAGE(S):            (801) 446-4428
  (801) 356-3636                          Huang, Adrian G                  McBee, William L                French/Spanish
  Madsen, Randall                         1234 N 900 E Ste 100                                             Priebe, Brandon M                    Orthodontist
                                          (801) 854-9140                   777 N 500 W Ste 102
  3355 N University Ave Ste 100                                            (801) 375-4707                  105 S 200 W
  (801) 356-3636                          Hulet, Gary M                                                    (435) 258-2301                  Baugh, Alan C
                                          777 N 500 W Ste 101B             Park, David A                                                   4019 W 12600 S Ste 210
  Osmond, Steven W                                                         3610 N University Ave Ste 150   FOREIGN LANGUAGE(S):
                                                                                                                                           (801) 253-6460
  3707 N Canyon Rd Ste 7B                 (801) 375-1275                                                   Spanish
                                                                           (801) 356-2226
  (801) 224-3200                          Iroz, David E                                                                                    Chipian, E Terry
                                          3330 N University Ave            Price, Christopher J                                            3409 W 12600 S
  Pulsipher, Richard J
  3355 N University Ave Ste 100           (801) 375-1965                   3610 N University Ave Ste 150
                                                                           (801) 356-2226
                                                                                                                Riverton                   (801) 999-4431
  (801) 356-3636                          Johnson, Jeffrey D                                                                               Randle, Brian T
                                          1275 N University Ave Ste 6                                                                      3409 W 12600 S
                                                                                     Pediatrics                 Endodontist                (801) 999-4431
     General Dentist                      (801) 375-9511
                                          Jones, Brian R                   Lund, Trace M                   Brimley, Curtis J               Talbot, Travis Q
  Ashman, Tyler                           3651 N 100 E Ste 200             745 N 500 W Ste 103             3409 W 12600 S Ste 120          2364 W 12600 S Ste 2C
  1355 N University Ave Ste 300           (801) 374-8218                   (801) 373-4200                  (801) 432-8200                  (801) 446-7175
  (801) 373-6928                                                                                                                           FOREIGN LANGUAGE(S):
                                          Lee, David G                     FOREIGN LANGUAGE(S):
  Benzon, Josef                           1675 N Freedom Blvd Ste 8A       French                             General Dentist              Spanish
  3330 N University Ave Ste A             (801) 356-7329                   Markham, Kevin R
  (801) 375-1965                          FOREIGN LANGUAGE(S):
                                                                                                           Borg, Brian D                             Pediatrics
                                                                           745 N 500 W Ste 103             3693 W 13400 S Ste A
  Booth, Chad K                           Spanish                          (801) 373-4200
  589 S State St                                                                                           (801) 878-3111                  Johnson, David
                                          Lorscheider, Michael H                                           Bromley, J Jacob                2364 W 12600 S Ste 1A
  Braithwaite, Larry A                    2476 N University Pkwy Ste 103        Periodontist               4019 W 12600 S Ste 100          (801) 253-8866
  1675 N Freedom Blvd Ste 12A             (801) 377-0990
  (801) 375-4600                                                           Bridge, Rod                     (801) 253-8633                  Martin, Eric E
                                          Moody, Daryn C                   745 N 500 W Ste 102             FOREIGN LANGUAGE(S):            12391 S 4000 W Ste 204
  Brimhall, Charles                       1355 N University Ave Ste 330                                    Spanish/Portuguese              (801) 676-8899
  85 W 500 N                                                               (801) 374-8002
                                          (801) 373-3150
  (801) 373-4878




(*) Accepting Established Patients ONLY                                                                                                                  Page 9
                                                           Participating Premier Providers

                                          Randle, Brian T              Watts, Robert K               Campbell, Jonathan G              Downing, Randy N
        Riverton                          3485 W 4800 S
                                          (801) 825-5200
                                                                       3730 W 4700 S
                                                                       (801) 955-8300
                                                                                                     1345 E 3900 S Ste 116
                                                                                                     (801) 278-4223
                                                                                                                                       7138 Highland Dr Ste 109
                                                                                                                                       (801) 572-1600
        (Cont'd)                                                                                     FOREIGN LANGUAGE(S):              Drury, Scot
                                                    Pediatrics            General Dentist            Spanish                           1400 Foothill Dr Ste B36
   Pediatrics (Cont'd)                    Anderson, John R             Allen, Franklin               Canfield, Steven M                (801) 582-9351
                                          3485 W 4800 S                6065 Highland Dr Ste 1        4970 S 900 E Ste D                Duke, David L
                                          (801) 774-5437               (801) 277-5181                (801) 261-3635                    420 E South Temple Ste 410
  Stevenson, Nathan D                                                                                Cannon, David H                   (801) 355-2202
  4019 W 12600 S Ste 200                                               Allen, Owen C                 1060 E 100 S Ste 307              Edmunds, Eli
  (801) 302-7938                                    Salem              6321 S Redwood Rd Ste 206
                                                                       (801) 747-0840                (801) 363-1321                    1638 W 6235 S
                                                                       Almond, Jeffrey S             Cannon, David S                   (801) 965-0617
      Roosevelt                              General Dentist           850 E 300 S Ste 7             1434 E 4500 S Ste 202             Egbert, Gregory W
                                                                       (801) 363-5652                (801) 274-3889                    1250 E 3900 S Ste 210
                                          Atwood, Michael R            Anderson, Kenneth R           Carroll, Kelly D                  (801) 265-1500
     General Dentist                      122 N 550 E                                                2114 Fort Union Blvd              Eggett, Michael
                                          (801) 798-3526               2290 E 4500 S Ste 180
  Elder, Scott D                                                       (801) 278-4131                (801) 943-2020                    1963 S 1200 E Ste 103
  481 W 200 N                             Bonny, James B               Aoki, Alan                    Cheney, Jess C                    (801) 466-1212
  (435) 722-0101                          245 State Road 198 Ste 6
                                                                       702 E South Temple Ste 105    2040 Murray Holladay Rd Ste 208   Ellis II, Richard L
  Knight, Michiel R                       (801) 423-2244                                             (801) 278-7100                    5 S 700 E Ste B30
                                          FOREIGN LANGUAGE(S):         (801) 322-4600
  168 W 300 N 75-5                                                     Austad, Thomas N              Chidester, Robert J               (801) 355-3263
  (435) 722-9995                          Spanish                                                    3730 W 4700 S                     Ellis III, Richard L
                                                                       2120 E 3900 S Ste 102
  Lemon, James N                          Guenter, Jeremy              (801) 274-2500                (801) 955-1900                    5 S 700 E Ste B30
  185 W 200 N                             204 E 400 N Ste C            FOREIGN LANGUAGE(S):          Chikaraishi, Todd                 (801) 355-3263
  (435) 722-2565                          (801) 504-6133
                                                                       German                        7138 Highland Dr Ste 214          Farris, Dustin J
  Talbot, Morrie                          FOREIGN LANGUAGE(S):                                       (801) 942-7770                    370 E South Temple Ste 220
  481 W 200 N                             Spanish                      Baird, Daniel R               Cho, Denny N                      (801) 355-8287
                                                                       461 S 400 E
  (435) 722-0101                          Hansen, David K              (801) 325-9538                1400 Foothill Dr Ste 36           Findley, Gary L
                                          204 E 400 N Ste A                                          (801) 583-4500                    4110 Highland Dr Ste 200
                                          (801) 423-0905               Barnes, Richard               FOREIGN LANGUAGE(S):              (801) 278-8800
             Roy                          Perry, Justin T              1955 S 1300 E Ste 1           Spanish/Korean                    FOREIGN LANGUAGE(S):
                                                                       (801) 487-5755
                                          40 S 200 W                                                 Christensen, David G              Spanish
     General Dentist                      (801) 423-1345               Barton, Jason G               508 E South Temple Ste 43         Fisher, William C
                                                                       928 E 100 S Ste E
                                                                                                     (801) 359-4732                    3730 W 4700 S
  Anderson, James V                                                    (801) 355-5657
  3626 W 5600 S Ste D                               Salina             FOREIGN LANGUAGE(S):          Christensen, Kurt D
                                                                                                     1580 E 3900 S Ste 110
                                                                                                                                       (801) 955-1900
                                                                                                                                       Frandsen, Joshua R
  (801) 985-2273                                                       Spanish
                                                                                                     (801) 272-8555                    2195 W 5400 S Ste 203
  Crookston, Michael                         General Dentist           Bevan, Curtis C               Christensen, Richard D            (801) 969-6740
  2779 W 4000 S Ste 101                                                4046 Highland Dr Ste 113                                        FOREIGN LANGUAGE(S):
  (801) 731-5528                          Asper, Mark W                (801) 272-9003                2319 Foothill Dr Ste 210
                                                                                                     (801) 467-6311                    Spanish
  Davidson, Collin                        3 E Main St                  Binns, Matthew R              Clark, Herald R                   Froerer, Jacob Scott
  4896 S 1900 W Ste C                     (435) 529-7441               586 W 5300 S Ste 103
  (801) 825-5928                          Dansie, Dan W                (801) 261-8200                3643 Highland Dr                  4110 Highland Dr Ste 200
                                                                                                     (801) 486-9434                    (801) 278-1164
  Felt, Jeremy                            20 E 200 N                   Black, Romney R               Clegg, Richard                    Gleave, Barton T
  3491 W 4800 S                           (435) 529-1000               4370 S Redwood Rd
  (801) 774-9354                          Sorenson, Barry K            (801) 969-1802                1377 E 3900 S Ste 105             5872 S 900 E Ste 200
                                                                                                     (801) 277-8222                    (801) 288-1818
  Greenhalgh, Jonathan                    20 E 200 N                   Blamires, Michael A           Cold, Scott P                     Goeckeritz, Chad
  4040 Midland Dr Ste 1                   (435) 529-7895               3730 W 4700 S
  (801) 317-4407                          Wilkins, Scott K             (801) 955-1900                4143 Carriage Sq                  2120 E 3900 S Ste 102
                                                                                                     (801) 965-9898                    (801) 274-2500
  FOREIGN LANGUAGE(S):                    145 N State St               Bliss, Andrew J               Coleman, C Ray                    Goldberg, Aaron S
  Spanish                                 (435) 529-7715               5630 Waterbury Way Ste B201
                                                                                                     3165 W 4700 S                     1050 E 3300 S Ste 103
  Hopkins, Paul D                                                      (801) 272-4621
                                                                                                     (801) 966-9956                    (801) 487-2206
  4902 S 1900 W                                Orthodontist            Boren, Don R                  Connolly, Dean B                  Greaves, Jesse N
  (801) 773-1234                                                       1580 E 3900 S Ste 110
                                          Oldroyd, Roger J             (801) 272-8555                1963 E 2700 S                     1401 E 3900 S Ste 102
  Howe, Chad V                            145 N State St                                             (801) 467-4747                    (801) 272-8051
  4902 S 1900 W                           (435) 529-7115               Brauer, Jack                  Connolly, Jeffrey D               FOREIGN LANGUAGE(S):
  (801) 776-1240                          FOREIGN LANGUAGE(S):         4110 Highland Dr
  FOREIGN LANGUAGE(S):                                                 (801) 274-1775                1963 E 2700 S                     Spanish
                                          Spanish                                                    (801) 467-4747                    Hadfield, Benjamin
  Spanish                                                              Brown, Layne C                Cottrell, Courtland G             530 E 500 S
  Isakson, Brent J                                                     1345 E 3900 S Ste 206
  3479 W 4800 S Ste C                     Salt Lake City               (801) 278-1333                3920 S 1100 E Ste 270
                                                                                                     (801) 266-5005
                                                                                                                                       (801) 747-8018
                                                                                                                                       Hamilton, Sanford
  (801) 773-8212                                                       Burg, Jeffrey S               Crook, Adon E                     1638 W 6235 S
  Moore, Scott E                               Endodontist             1580 E 3900 S Ste 110
                                                                                                     1365 W 1000 N                     (801) 264-0617
  4896 S 1900 W Ste B                                                  (801) 272-8555
  (801) 773-9198                          Christensen, Joseph D        Burns, Noel E
                                                                                                     (801) 328-5756                    Hamilton, Shawn M
  Neeley, J. Christian                    370 E South Temple Ste 350   6070 S 1300 E                 Dansie, Dan W                     1638 W 6235 S
                                          (801) 320-9810               (801) 266-7831                2222 W 3500 S                     (801) 264-0617
  4040 Midland Dr Ste 1
  (801) 317-4407                          Coats, John M                Burns, Walter R
                                                                                                     (801) 304-9391                    Hanna, Paul D
  Olson, C Brook                          7138 Highland Dr Ste 109     3378 S 2300 E                 Devries, Bradley E                7086 S Highland Dr 100
                                          (801) 942-8686               (801) 486-1500                1060 E 100 S Ste 205              (801) 942-5520
  4902 S 1900 W                                                                                      (801) 355-3286                    FOREIGN LANGUAGE(S):
  (801) 776-1240                          Madsen, Randall              Bye, Walter Landon
  FOREIGN LANGUAGE(S):                    7138 Highland Dr Ste 109     175 S West Temple Ste 100     Dickerson, Darin                  German
  Spanish                                 (801) 942-8686               (801) 364-7943                370 E South Temple Ste 350        Hanzon, Jeff
                                                                                                     (801) 320-9810                    2120 E 3900 S Ste 100
  Packard, Jonathan D                     Pulsipher, Richard J         Callan, Mark James
  3505 W 4800 S                           7138 Highland Dr Ste 109     370 E South Temple Ste 220    Dickson, R Scott                  (801) 274-2500
  (801) 985-3300                          (801) 942-8686               (801) 355-8287                2040 Murray Holladay Rd Ste 200   Hartvigsen, Darin
                                                                                                     (801) 277-1424                    1377 E 3900 S
  Palmer, Robert                          Richards, Robert S           FOREIGN LANGUAGE(S):
  3505 W 4800 S                           1060 E 100 S Ste 301         Spanish                       Dillman, Ray E                    (801) 277-8222
  (801) 985-3300                          (801) 322-4501               Campbell, Galen               3060 S Redwood Rd                 Hatsis, George C
                                          FOREIGN LANGUAGE(S):                                       (801) 972-0555                    1060 E 100 S Ste 205
  Wade, Glen L                                                         1345 E 3900 S Ste 116         FOREIGN LANGUAGE(S):              (801) 355-3286
  5139 S 1900 W                           Japanese                     (801) 278-4223
                                                                                                     Spanish                           Hicken, Clark
  (801) 773-7721                          Rudd, Mitchell G             FOREIGN LANGUAGE(S):
                                          1955 S 1300 E Ste 6          Spanish                       Dowling, Ryan S                   370 E South Temple Ste 350
                                                                                                     2180 Fort Union Blvd              (801) 320-9810
       Orthodontist                       (801) 487-0758
                                                                                                     (801) 944-4141                    Holmberg II, William R
                                          Sonntag, Keith D                                           FOREIGN LANGUAGE(S):
  Naylor, Paul                            2180 E 4500 S Ste 280                                                                        1377 E 3900 S Ste 202
  3485 W 4800 S                           (801) 274-6900                                             Spanish                           (801) 274-7700
  (801) 825-5200



(*) Accepting Established Patients ONLY                                                                                                             Page 10
                                                             Participating Premier Providers

                                          Mangrum, Kelly A              Pond, W Henry                Smith, David O                Walker, Bradley S
  Salt Lake City                          7110 Highland Dr
                                          (801) 943-6880
                                                                        688 E Vine St Ste 16
                                                                        (801) 262-8728
                                                                                                     5 S 700 E Ste 204
                                                                                                     (801) 355-7021
                                                                                                                                   3920 S 1100 E Ste 330
                                                                                                                                   (801) 262-9785
     (Cont'd)                             Marberger, Adam               FOREIGN LANGUAGE(S):         Smith, Gregory                Walton, Troy R
                                          4110 Highland Dr Ste 100      French/Tahitian              370 E South Temple Ste 350    461 S 400 E
     General Dentist                      (801) 272-0271                Pope, Marcus R               (801) 320-9810                (801) 325-9538
                                          Matheson, Michael K           928 E 100 S Ste E            Smith, J Joshua               FOREIGN LANGUAGE(S):
        (Cont'd)                          3939 Wasatch Blvd Ste 4       (801) 355-5657               2180 E 4500 S Ste 250         Spanish
                                          (801) 424-0027                FOREIGN LANGUAGE(S):         (801) 272-8609                Ward, R Charles
  Holmberg, William R                     Maughan, Willard W            Portuguese                   Smith, Michael T              575 E 4500 S Ste B220
  1377 E 3900 S Ste 202                   530 E 500 S                   Pope, Steven R               2180 E 4500 S Ste 225         (801) 261-3622
  (801) 274-7700                          (801) 747-8018                6087 S Redwood Rd Ste A      (801) 278-4431                FOREIGN LANGUAGE(S):
  FOREIGN LANGUAGE(S):                    McLachlan, Adam P             (801) 969-7282               FOREIGN LANGUAGE(S):          Italian
  Spanish/Russian                         154 E 5065 S Ste 203          Porter, Paul M               Portuguese                    Warner, James W
  Howarth, John H                         (801) 590-8150                215 S 1000 E Ste A           Snyder, Matthew G             1060 E 100 S Ste 205
  5630 S 1475 E Ste B-201                 Meeks, Daniel                 (801) 328-4173               2681 Parleys Way Ste 207      (801) 355-3286
  (801) 272-4621                          370 E South Temple Ste 350    FOREIGN LANGUAGE(S):         (801) 485-2627                Warren, Mark
  Howe, Douglas H                         (801) 320-9810                German                       Sperry, Jeffrey S             461 S 400 E
  4252 Highland Dr Ste 103                Meier, Joseph V               Porter, R Von                2000 S 1300 E                 (801) 325-9538
  (801) 274-2034                          921 Executive Park Dr Ste D   6087 S Redwood Rd Ste A      (801) 484-8893                Watson, Michael
  Hutchings, Brent R                      (801) 268-8066                (801) 969-7282               Sperry, Steven M              1401 E 3900 S Ste 202
  440 S 700 E Ste 305                     FOREIGN LANGUAGE(S):          Proctor, Craig R             2000 S 1300 E                 (801) 278-0704
  (801) 363-1213                          German                        2936 Highland Dr Ste 200     (801) 484-8893                Weaver, Jared M
  Hutchings, Michael B                    Menlove, Benjamin             (801) 486-2800               Steele, Richard H             2011 S 1300 E
  440 S 700 E Ste 305                     370 E South Temple Ste 350    Ramsdell, Christopher        370 E South Temple Ste 350    (801) 484-0792
  (801) 363-1213                          (801) 320-9810                M                            (801) 320-9810                West, Daniel
  Jensen, Jay D                           Menlove, Benjamin R           1365 W 1000 N                Stohl, David R                5292 College Dr Ste 203
  3098 Highland Dr Ste 400                1580 E 3900 S Ste 110         (801) 328-5756               2120 S 700 E Ste 1            (801) 266-3000
  (801) 467-9111                          (801) 272-8555                Reading, Tyler               (801) 582-5787                Williams, Zachary T
  Johnson, Robert                         FOREIGN LANGUAGE(S):          3730 W 4700 S                Stohl, John L                 1949 E 5600 S
  3730 W 4700 S                           Portuguese                    (801) 955-1900               1355 Foothill Dr Ste 100      (801) 277-8395
  (801) 955-1900                          Meyers, John                  Reber, Richard E             (801) 582-5787                Winder, George
  Jones, Drew                             2240 Murray Holladay Rd       1996 E 6400 S Ste 220        Stohl, Matthew R              3730 W 4700 S
  7050 Highland Dr Ste 240                (801) 277-1010                (801) 943-2627               2120 S 700 E Ste I            (801) 955-1900
  (801) 942-6464                          Muse, Gregrey L               Reid, Bruce H                (801) 582-5787                Wolthuis, Jared
  FOREIGN LANGUAGE(S):                    4460 Highland Dr Ste 400      5292 College Dr Ste 203      Stoker, Brigham R             55 N Redwood Rd Ste B
  Sign                                    (801) 272-4111                (801) 266-3000               144 S 700 E                   (801) 519-2222
  Kimball, Don H                          FOREIGN LANGUAGE(S):          Reschke, John                (801) 505-6850                Woodbury, Spencer
  2860 W 4700 S Ste A                     Spanish                       370 E South Temple Ste 350   Storheim, John E              2120 E 3900 S Ste 102
  (801) 968-1142                          Nguyen Tran, Hanhngan         (801) 320-9810               211 S 700 E                   (801) 274-2500
  FOREIGN LANGUAGE(S):                    H                             Roberson, Jeffrey            (801) 355-3151                Workman, Ryan
  Spanish                                 445 E 4500 S Ste 150          3730 W 4700 S                Stringfellow, Corbin B        1949 E 5600 S
  Knudson, Darin R                        (801) 671-8714                (801) 955-1900               1345 E 3900 S Ste 208         (801) 277-8395
  1955 S 1300 E Ste 1                     Odonoghue, Bruce J            Roberts, Kim G               (801) 273-8284                Wright, Aaron D
  (801) 487-5755                          1951 W 4700 S Ste 5           4046 Highland Dr Ste 114     Suekawa, Todd S               370 E South Temple Ste 350
  Lafeber, Nicholas B                     (801) 969-1800                (801) 424-3500               2178 S 900 E Ste 5            (801) 320-9810
  2160 E 4500 S Ste 3                     FOREIGN LANGUAGE(S):          Rosander, Kris H             (801) 487-4606                Wright, Aaron David
  (801) 277-9213                          Spanish                       4802 Holladay Blvd           Sumarauw, Cindy               3730 W 4700 S
  Lapine, John Paul                       Oldroyd, Alexander            (801) 733-7035               1345 E 3900 S Ste 204         (801) 955-1900
  3865 Wasatch Blvd Ste 201               1949 E 5600 S                 Roundy, Evan M               (801) 272-2949                Wright, James M
  (801) 272-4999                          (801) 277-8395                7138 Highland Dr Ste 215     Swensen, Eric J               32 N State St
  Larson, Eric A                          Olsen, Phillip                (801) 943-9194               4046 Highland Dr Ste 115      (801) 359-2655
  928 E 100 S                             3730 W 4700 S                 FOREIGN LANGUAGE(S):         (801) 277-1412                Yates, Robert W
  (801) 355-4733                          (801) 955-1900                Spanish                      Theurer, Craig B              6936 Promenade Dr Ste 202
  Larson, Matthew B                       Olson, Craige J               Rudelich, Nick J             1955 S 1300 E Ste L1          (801) 943-4577
  928 E 100 S                             50 N Medical Dr               5255 S 4015 W Ste 180        (801) 487-5805                Yates, Troy W
  (801) 355-5559                          (801) 581-2121                (801) 968-9003               Thompson, Rudy                6936 Promenade Dr Ste 202
  Larson, Scott A                         Orme, Thomas R                Rupp, Jeffery K              1909 W 4700 S                 (801) 943-4577
  928 E 100 S                             2043 E 2700 S                 1955 S 1300 E Ste 7          (801) 968-9548
  (801) 355-3322                          (801) 467-4874                (801) 463-1900               Thorup, Robert R                    Oral Surgeon
  Lewis, Kent S                           Otto, Stephan W               Russell, Kenneth             7138 Highland Dr Ste 218
                                                                                                                                   Anderson, Lowell K
  4970 S 900 E Ste G                      6321 S Redwood Rd Ste 206     2160 S 10th E                (801) 944-9494
                                                                                                                                   7138 Highland Dr Ste 211
  (801) 262-9444                          (801) 747-0840                (801) 466-2984               Tidwell, Anthony C            (801) 943-8703
  FOREIGN LANGUAGE(S):                    Parkin, Richard A             Russell, Roger T             4110 Highland Dr Ste 200
  French                                                                                             (801) 278-1164                Austin, Blaine D
                                          4046 Highland Dr Ste 113      7138 Highland Dr Ste 101                                   2180 E 4500 S Ste 285
  Liddle, Stephen B                       (801) 272-9003                (801) 943-1625               Tillmann, Ruediger            (801) 277-3942
  7069 Highland Dr Ste 200                Patton, Bekki T               Scott, Kyle S                5872 S 900 E Ste 202          FOREIGN LANGUAGE(S):
  (801) 943-2222                          500 S 530 E                   3060 S Redwood Rd            (801) 281-8433
                                                                                                                                   Spanish
  Lindgren, Jeremiah M                    (801) 747-8018                (801) 972-0555               Todd, Douglas M               Baldwin, Kenneth J
  3730 W 4700 S                           Pearson, G George             Sergakis, William M          223 S 700 E
  (801) 955-1900                                                                                     (801) 355-6997                4046 Highland Dr Ste 112
                                          1955 S 1300 E Ste L1          7240 Highland Dr Ste 102                                   (801) 273-5600
  Link, Devin M                           (801) 487-5805                (801) 467-6018               FOREIGN LANGUAGE(S):
  1365 W 1000 N                                                                                      Spanish                       Benson, Paul D
                                          Peterson, Burke B             FOREIGN LANGUAGE(S):                                       530 E 500 S
  (801) 328-5750                          250 E Broadway Ste 310        Greek                        Topham, David Scott           (801) 747-8000
  Lowe, Steven B                          (801) 322-4082                Shields, Jay G               3060 S Redwood Rd
                                                                                                                                   Cannon, Grant B
  7138 Highland Dr Ste 212                Peterson, Dennis W            420 E South Temple Ste 410   (801) 972-0555
                                                                                                                                   4190 Highland Dr Ste 112
  (801) 943-0901                          1365 W 1000 N                 (801) 355-2202               Updike, Spencer T             (801) 272-9241
  Lucas, Sean P                           (801) 328-5756                Slater, Rodney J             530 E 500 S
                                                                                                                                   Christensen, Steven E
  7186 Highland Dr Ste 100                Pickett, Victor O             1580 E 3900 S Ste 110        (801) 747-8018
                                                                                                                                   6243 S Redwood Rd Ste 100
  (801) 453-0244                          5255 S 4015 W                 (801) 272-8555               Van Alfen, Craig              (801) 269-1110
  Ludlow, Thomas H                        (801) 968-9003                Smith, Brian W               5630 Waterbury Way Ste B203
                                                                                                                                   Flint, Robert L
  850 E 300 S Ste 3                       Pinegar, Steven C             6360 S 3000 E Ste 330        (801) 278-4607
                                                                                                                                   4970 S 900 E Ste C
  (801) 355-0380                          1345 E 3900 S Ste 206         (801) 943-5443               Voorhees, I Darrell           (801) 263-3309
  Luke, Spencer D                         (801) 278-1333                Smith, Craig T               1343 Fort Union Blvd
                                                                                                                                   Jessen, Shane G
  1011 Catherine St                       Pollock, Hal G                4046 Highland Dr             (801) 943-3661
                                                                                                                                   530 E 500 S
  (801) 596-3000                          1345 E 3900 S Ste 212-A       (801) 277-1412
                                          (801) 278-2826



(*) Accepting Established Patients ONLY                                                                                                          Page 11
                                                             Participating Premier Providers

                                                                          Homer, Brian L                  Sonnenberg, Brent C
  Salt Lake City                                    Sandy                 7369 Creek Rd
                                                                          (801) 943-6308
                                                                                                          8941 S 700 E Ste 201
                                                                                                          (801) 256-3636
                                                                                                                                              Santaquin
     (Cont'd)                                                             Hughes, Richard                 Steele, Richard H
                                               Endodontist                9844 S 1300 E Ste 340           10011 Centennial Pkwy Ste 330      General Dentist
                                          Christensen, Joseph D           (801) 572-4261                  (801) 256-3700                  Chisholm, Jon R
        Oral Surgeon                                                      Jackson, David E                Vernon, Andrew M
                                          10011 Centennial Pkwy Ste 330                                                                   10 S 300 W
          (Cont'd)                        (801) 256-3700                  870 E 9400 S Ste 110            10011 Centennial Pkwy Ste 330   (801) 754-0678
                                          Watts, Robert K                 (801) 571-8391                  (801) 256-3700                  Huntington, Gavin
  McBee, William L                        10011 Centennial Pkwy Ste 330   Jensen, Steven                  Winder, George                  340 E Main St Ste 5
  2080 Murray Holladay Rd                 (801) 256-3700                  880 E 9400 S Ste 101            10011 Centennial Pkwy Ste 330   (801) 754-3100
  (801) 278-3108                                                          (801) 553-1616                  (801) 566-5987
  Stoker, David S                            General Dentist              Johansen, Stephen               Woodward, Brandon
  4190 Highland Dr Ste 112                                                7370 Creek Rd Ste 202           7430 Creek Rd Ste 101                Saratoga
  (801) 272-9241                          Austad, Thomas N                (801) 676-1234                  (801) 561-8131                        Springs
                                          10011 Centennial Pkwy Ste 330   Johnson, Robert                 Wright, Aaron D
            Orthodontist                  (801) 566-5987                  10011 Centennial Pkwy Ste 330   10011 Centennial Pkwy Ste 330
                                          Bangash, Shazmeena              (801) 566-5987                  (801) 256-3700                     General Dentist
  Baird, Brian W                          8757 Highland Dr                Kim, Steve
  5547 S 4015 W Ste 3                     (801) 947-0505                                                                                  Cerny, William
  (801) 967-3337                                                          10450 S State St Ste 1210           Oral Surgeon                1376 Redwood Rd
                                          Bawden, Hal                     (801) 576-7500
  Broadwater, Paul M                      10011 Centennial Pkwy Ste 210   FOREIGN LANGUAGE(S):            Anderson, David M               (801) 766-2112
  2080 Murray Holladay Rd                 (801) 256-0808                                                  7390 Creek Rd Ste 101           FOREIGN LANGUAGE(S):
  (801) 278-7272                                                          Korean                          (801) 255-2422                  Spanish
                                          FOREIGN LANGUAGE(S):
  Endrizzi, Mark T                        Spanish
                                                                          Lafeber, Nicholas B             Jessen, G Shane                 Faerber, David E
  3730 W 4700 S                                                           8941 S 700 E Ste 101            9730 S 700 E Ste 106            1314 Redwood Rd # 102
  (801) 955-1900
                                          Benzon, Josef A                 (801) 566-0660                  (801) 571-3311                  (801) 768-0440
                                          8757 Highland Dr                Larsen, Gregory P
  Fenton, Andrew R                        (801) 947-0505                                                  FOREIGN LANGUAGE(S):            Greenwood, Brandon D
  370 E South Temple Ste 350                                              7370 Creek Rd Ste 104           Spanish                         76 E Commerce Dr Ste 101
  (801) 320-9810
                                          Blamires, Michael A             (801) 566-4100                                                  (801) 766-3269
                                          575 E University Pkwy A-24      Larson, Matthew B
  Holman, Brian G                         (801) 764-9069                  9457 S 700 E
                                                                                                               Orthodontist               Greenwood, Dale M
  1345 E 3900 S Ste 202                   Brain, Patrick R                                                                                76 E Commerce Dr Ste 101
  (801) 278-2819                                                          (801) 572-5550                  Baird, Brian W                  (801) 766-3269
                                          1030 E 11400 S Ste C            Lindgren, Jeremiah M            10011 Centennial Pkwy Ste 330
  FOREIGN LANGUAGE(S):                    (801) 572-0100                                                  (801) 256-3700                  Hudson, Sascha
  Italian                                                                 10011 Centennial Pkwy Ste 330                                   1376 Redwood Rd
                                          Callahan, Duane D               (801) 566-5987                  Carter, Gary A                  (801) 766-2112
  Holman, R Gayle                         8706 S 700 E Ste 100            Lindsay, Stuart K               10011 Centennial Pkwy Ste 240
  1345 E 3900 S Ste 202                   (801) 255-3351                                                  (801) 255-9000                  Loeser, Michael
  (801) 278-2819                                                          7430 Creek Rd Ste 101                                           1376 Redwood Rd
  FOREIGN LANGUAGE(S):
                                          Carlson, Tyler B                (801) 561-8131                  Cook, Michael J                 (801) 766-2112
                                          7369 Creek Rd                   Mansell, Kevin                  1025 E 11400 S Ste 103
  Spanish                                 (801) 566-5577                                                                                  FOREIGN LANGUAGE(S):
                                                                          1030 E 11400 S Ste 102          (801) 523-2509
  Knudson, Peter C                        Chandler, Nathan E                                                                              Spanish
  1060 E 100 S Ste 201
                                                                          (801) 572-2250                  Iverson, Jeffrey A              Macdonald, David
                                          870 E 9400 S Ste 101            FOREIGN LANGUAGE(S):            850 E 9400 S Ste 201
  (801) 466-4600                          (801) 571-3446                                                                                  245 E State Road 73
                                                                          Spanish                         (801) 571-9664
                                                                                                                                          (801) 766-8410
  Parker, Justin O                        Chidester, Robert J             Masson, Daniel L                Jackson, Charles B
  2090 E 2100 S                           10011 Centennial Pkwy Ste 330                                   669 Union Sq
                                                                                                                                          Matthews, Jeremy B
  (801) 262-1500                                                          9457 S 700 E                                                    1305 N Commerce Dr Ste 220
                                          (801) 256-3700                  (801) 572-5550                  (801) 571-1231
  Price, Cory D                           Christensen, Craig M                                                                            (801) 766-4944
  370 E South Temple Ste 350                                              Meeks, Daniel                   Parker, Justin O                Park, Kwang
                                          9455 Union Sq                   10011 Centennial Pkwy Ste 330   7369 Creek Rd
  (801) 320-9810                          (801) 571-5050                                                                                  1376 Redwood Rd
                                                                          (801) 566-5987                  (801) 262-1500
  Randle, Brian T                         Curtis, Cabot                                                                                   (801) 766-2112
  1140 Brickyard Rd Ste 32                                                Menlove, Benjamin                                               FOREIGN LANGUAGE(S):
  (801) 474-9553
                                          7430 Creek Rd Ste 101           575 E University Pkwy Ste A24             Pediatrics            Korean
                                          (801) 561-8131                  (801) 225-3300
                                          Dibble, Kenneth R                                               Boren, Don R                    Walker, Bradley S
             Pediatrics                                                   Olsen, Phillip                  1030 E 11400 S Ste 1            1376 Redwood Rd
                                          9853 S 700 E                    10011 Centennial Pkwy Ste 330
                                          (801) 572-4430                                                  (801) 553-8882                  (801) 766-2112
  Knudson, Darin R                                                        (801) 566-5987
                                                                                                          Burg, Jeffrey S                 FOREIGN LANGUAGE(S):
  1580 E 3900 S Ste 110                   Dickerson, Darin                Owens, Robert W
  80127285555                             10011 Centennial Pkwy Ste 330                                   1030 E 11400 S Ste 101          Spanish
                                                                          8045 S 700 E Ste 5              (801) 553-8882
  Romney, Lawrence C                      (801) 256-3700                  (801) 561-5191                                                  Young, Christopher
                                          Dowdle, Daniel R                                                Knudson, Darin R                1376 Redwood Rd
  525 E 100 S Ste 430                                                     Packer, Randell B               1030 E 11400 S Ste 101          (801) 766-2112
  (801) 355-8677                          9853 S 700 E                    8238 S 700 E Ste 202
                                          (801) 572-4430                                                  (801) 553-8882                  FOREIGN LANGUAGE(S):
  Romney, Walter A                                                        (801) 566-4697
                                                                                                          Rooklidge, Erik                 Spanish
  525 E 100 S Ste 430                     Duke, David L                   Perkins, Gregory D
  (801) 355-8677                          9457 S 700 E                    7430 Creek Rd Ste 100
                                                                                                          10011 Centennial Pkwy Ste 250   Young, Michael W
                                          (801) 572-5505                                                  (801) 562-2222                  1376 Redwood Rd
  FOREIGN LANGUAGE(S):                                                    (801) 255-4870
  Spanish                                 Easton, R Jeff                                                  Segura, Stuart D                (801) 766-2112
                                                                          Phillips, Shane L               1030 E 11400 S Ste 101
  Segura, Stuart D                        850 E 9400 S                    850 E 9400 S Ste 100
  1580 E 3900 S Ste 110                   (801) 571-3400                  (801) 255-2100
                                                                                                          (801) 553-8882                      Oral Surgeon
  (801) 272-8555                          Ellingson, Daniel               Randall, Gregory J                                              Burton, Christopher C
                                          1844 E 9400 S                   9141 Village Shop Dr
                                                                                                               Periodontist               76 E Commerce Dr Ste 203
            Periodontist                  (801) 816-9366                  (801) 727-2626                  Rizzo, Richard J                (801) 768-3200
                                          Fisher, William C               Reading, Tyler                  10011 Centennial Pkwy Ste 330   Nicholls, David W
  Bills, Kenneth B                        10011 Centennial Pkwy Ste 330   10011 Centennial Pkwy Ste 330   (801) 256-3700                  76 E Commerce Dr Ste 203
  2180 E 4500 S Ste 240                   (801) 566-5987
  (801) 277-0090                                                          (801) 256-3700                                                  (801) 768-3200
                                          Gilstrap, Benjamin L            Reschke, John                     Santa Clara
  Chaston, Reve                           880 E 9400 S Ste 104            10011 Centennial Pkwy Ste 330                                             Pediatrics
  3730 W 4700 S                           (801) 571-5081                  (801) 566-5987
  (801) 955-1900                          Haymond, Creed S                Roberson, Jeffrey                  General Dentist              Rupp, Jeffery
  Rizzo, Richard J                        1434 E 9400 S Ste 102           10011 Centennial Pkwy Ste 330
                                                                                                                                          76 E Commerce Dr Ste 100
  370 E South Temple Ste 350              (801) 576-0077                                                  Moore, Nathan S                 (801) 766-4900
                                                                          (801) 566-5987                  2313 Santa Clara Dr
  (801) 320-9810                          Hicken, Clark                   Slater, Rodney J                                                Smith, Nathan E
                                                                                                          (435) 652-4100                  245 E State Road 73
                                          10011 Centennial Pkwy Ste 330   1030 E 11400 S Ste 101
      Prosthodontist                      (801) 566-5987                  (801) 553-8882
                                                                                                          Redd, Jay D                     (801) 756-6048
                                          Hickman, William                                                2301 Santa Clara Dr Ste D       Tew, Michael C
  Winegar, Troy H                                                         Smith, Gregory                  (435) 688-1577                  76 E Commerce Dr Ste 100
  1931 E 5600 S                           10011 Centennial Pkwy Ste 330   10011 Centennial Pkwy Ste 330
  (801) 272-0423                          (801) 256-3700                                                  Sigrist, Tom                    (801) 766-4900
                                                                          (801) 566-5987                  2301 Santa Clara Dr
                                                                                                          (435) 688-1577




(*) Accepting Established Patients ONLY                                                                                                                Page 12
                                                           Participating Premier Providers

                                          Lund, James D                                            Sorensen, Bret J
      Smithfield                          10430 S 2700 W                   South Ogden             497 N Main St                    Pediatrics
                                          (801) 254-7777                                           (801) 798-2100            Chamberlain, Darren D
                                          Maymi, Gerardo                                           FOREIGN LANGUAGE(S):      1795 W 500 S Ste 3B
     General Dentist                      3672 W South Jordan Pkwy Ste         Orthodontist        Spanish                   (801) 489-1301
  Godderidge, Bruce H                     203                             Knudson, Peter C         Sorensen, David J         Evershed, Morgan P
                                          (801) 253-7553                                           90 W 600 N
  291 S Main St Ste A                                                     448 E 5350 S Ste A                                 1795 W 500 S Ste B3
  (435) 563-6213                          FOREIGN LANGUAGE(S):            (801) 479-8980           (801) 798-3296            (801) 489-1301
  Harris, Chad M                          Spanish                                                  FOREIGN LANGUAGE(S):
                                          McInnes, Matthew S                                       Russian/German
  1189 S Main St
  (435) 563-3025                          3556 W 9800 S Ste 102              South Salt            Sorensen, W Thomas            St George
  Lyman, Scott M                          (801) 280-5558
                                          Meden, Walter
                                                                               Lake                90 W 600 N
  130 W 700 S Ste B
                                          1680 Reunion Ave Ste 200
                                                                                                   (801) 798-2616               General Dentist
  (435) 563-0140
  Webber, Darren S                        (801) 446-7800                     General Dentist            Orthodontist         Albrecht, John
                                          FOREIGN LANGUAGE(S):                                                               1150 S Bluff St Ste 1
  130 W 700 S Ste B
                                          Spanish                         Peterson, Dennis W       Francis, Karl M           (435) 628-8885
  (435) 563-0140                                                          1798 S West Temple       375 W Center St
  FOREIGN LANGUAGE(S):                    Miller, David W                 (801) 328-5756
                                                                                                                             Albrecht, Joshua D
                                                                                                   (801) 798-8226            1150 S Bluff St
  Spanish                                 10393 S 1300 W                  Troili, Dean
                                          (801) 254-1400                                           Lee, Adam N               (435) 628-8885
                                                                          3195 S Main St # 200     389 N Main St             Alldredge, D Bryce
                                          Miller, John D
  South Jordan                            10393 S 1300 W
                                                                          (801) 486-0301
                                                                          Ttroili, Dean C
                                                                                                   (801) 798-1118
                                                                                                   FOREIGN LANGUAGE(S):
                                                                                                                             1240 E 100 S Ste 17
                                          (801) 254-1400                                                                     (435) 652-9105
                                                                          3195 S Main St Ste 200   Portuguese                Baker, Susan M
     General Dentist                      Morris, Derek R                 (801) 468-0301
                                          10393 S 1300 W                                           Trapnell, Christopher J   1449 N 1400 W Ste A-1
  Allen, S Todd                           (801) 254-1400                                           89 W 900 N                (435) 656-2800
  3672 W South Jordan Pkwy Ste            Myers, John                     Spanish Fork             (801) 798-8343            Banks, Steven H
  201                                     3648 W 9800 S                                            Trapnell, Gregory J       444 E Tabernacle St Ste 1
  (801) 260-0400                          (801) 260-0100                                           89 W 900 N                (435) 673-6614
  Alvord, David L                         Rush, Ryan K
                                                                               Endodontist         (801) 798-8343            Blake, Clinton L
  1685 Towne Center Dr Ste A2             3648 W 9800 S                   Vanmoorlehem, Ryan                                 437 S Bluff St Ste 102
  (801) 254-7003                          (801) 260-0100                  826 N 100 E Ste 3                  Pediatrics      (435) 688-2772
  Babcock, David                          Scott, Jay D                    (801) 504-6070           Wing, Ryan                Brown, Michael Rory
  3672 W South Jordan Pkwy Ste            10433 S Redwood Rd              FOREIGN LANGUAGE(S):     497 N Main St             1240 E 100 S Bldg 22
  201                                                                     Spanish                                            (435) 634-9933
  (801) 260-0400                          Smith, Steven D                                          (801) 798-2100
                                          1268 W South Jordan Pkwy Ste                                                       Buchanan, Julie
  Babcock, David M                                                           General Dentist                                 382 S Bluff St Ste 200
  3672 W South Jordan Pkwy Ste
                                          302
                                          (801) 260-9150                                              Springville            (435) 628-6168
  201                                                                     Atwood, Richard M                                  Christensen, Brett K
  (801) 260-0400                          Sorensen, Steven                82 E 900 N Ste A
                                          3648 W 9800 S                                               General Dentist        352 E Riverside Dr Ste C1
  Bess, John Shea                                                         (801) 798-3526                                     (435) 688-8827
                                          (801) 260-0100                  FOREIGN LANGUAGE(S):
  3556 W 9800 S Ste 102
                                          Stark, John D                                            Asay, Daniel W            Christensen, Louis R
  (801) 280-5558                                                          Spanish                  330 E 400 S Ste 3         1404 Sunriver Pkwy Ste 125
                                          1258 W South Jordan Pkwy Ste    Briggs, Shaun S
  Blackhurst, David                       204
                                                                                                   (801) 489-9494            (435) 256-6167
  3648 W 9800 S                           (801) 254-0713                  826 N 100 E Ste 5        Baird, Robert M           Cox, Dan M
  (801) 260-0100                                                          (801) 798-0061           1795 W 500 S Ste B2
                                          Willden, Ryan H                 Brockbank, Wells S
                                                                                                                             640 E 700 S Ste 10A
  Curtis, Cabot                           3632 W South Jordan Pkwy Ste
                                                                                                   (801) 491-6920            (435) 652-1212
  3672 W South Jordan Pkwy D104           202                             490 N Main St            Blume, Dennis             Denos, Richard L
  (801) 878-1700                          (801) 446-4668                  (801) 798-9874           143 E 200 S               437 S Bluff St Ste 101
  Downing, Randy                          Woodward, Brandon T             Buhler, Cameron S        (801) 489-4541            (435) 628-0800
  3648 W 9800 S                           3672 W South Jordan Pkwy D104   63 E 800 N               Francis, Richard W        Dockstader, Jeremy R
  (801) 260-0100                          (801) 878-1700                  (801) 794-9905           378 E 400 S Ste 1         321 N Mall Dr Ste P101
  Dunn, J Michael                                                         Buhler, Forrest S        (801) 489-9456            (435) 674-1418
  11659 S Redwood Rd                          Oral Surgeon                63 E 800 N               Hadley, Dale C            Dorius, Kevin S
  (801) 253-3010                                                          (801) 794-9905           378 E 400 S Ste 1         929 W Sunset Blvd Ste 15
  Faerber, David                          Bateman, Adam R                 Cloward, Aaron D         (801) 489-9456            (435) 656-5900
  3648 W 9800 S                           3632 W South Jordan Pkwy Ste    83 W 900 N               Jackson, Jonathan
                                          104                             (801) 794-1834
                                                                                                                             Dyer, Bricanei A
  (801) 260-0100                                                                                   335 E 400 S               1150 S Bluff St Ste 1
  Harris, Daniel L                        (801) 253-6117                  Dansie, Dan W            (801) 489-4411            (435) 628-8885
  10393 S 1300 W                          Israelsen, L Douglas            128 W 900 N Ste A        FOREIGN LANGUAGE(S):
                                          3648 W 9800 S                   (801) 794-3224
                                                                                                                             Earl, Darren B
  (801) 254-1400                                                                                   Russian                   321 N Mall Dr Ste F102
                                          (801) 397-2727                  Davis, William C
  Hart, Brody                                                                                      Marshall, Kyle R          (435) 656-4550
  3648 W 9800 S                           Smoot, David J                  665 E 300 S              378 E 400 S Ste 1
                                          2651 W South Jordan Pkwy Ste    (801) 798-8496
                                                                                                                             Ence, Eric J
  (801) 260-0100                                                                                   (801) 489-9456            10 Diagonal St Ste 102
                                          102                             Fairbanks, Jon C
  Henrickson, R Heath                     (801) 253-4352                                           Miner, Alan C             (435) 673-0964
  3648 W 9800 S                                                           83 W 900 N               330 E 400 S Ste 4         Ence, I Lee
  (801) 260-0100                                                          (801) 794-1834           (801) 489-4540
  Keefe, Chris W                               Orthodontist               Greenhalgh, Jennifer     FOREIGN LANGUAGE(S):
                                                                                                                             10 Diagonal St Ste 102
                                                                                                                             (435) 628-6026
  10393 S 1300 W                          Ghiz, Matthew                   312 N Main St            Spanish                   Ence, James N
  (801) 254-1400                          3672 W South Jordan Pkwy Ste    (801) 794-9684           Nance, David K            754 S Main St Ste 1
  Liddiard, K John                        201                             Hansen, Kent B           285 E 400 S               (435) 628-2667
  10458 S Redwood Rd                      (801) 260-0400                  290 W Center St          (801) 489-1000
                                                                          (801) 798-7464
                                                                                                                             Ence, Mark R
  (801) 302-8989                                                                                   Perkins, Robert N         754 S Main St Ste 1
  Lindsay, Stuart                                   Pediatrics            Hassan, Amira            335 E 400 S               (435) 628-2667
  3672 W South Jordan Pkwy D104                                           290 W Center St          (801) 489-4411            Ence, Nathan
  (801) 878-1700
                                          Farnsworth, Russell             (801) 969-2121
                                          2651 W South Jordan Pkwy Ste                             Wright, David N           10 Diagonal St Ste 102
  Lord, Brian J                           103                             Hilmo, Justin            378 E 400 S Ste 1         (435) 628-6026
  3785 W South Jordan Pkwy Ste            (801) 446-1515                  826 N 100 E Ste 1        (801) 489-9456            Erickson, Verd J
  103                                                                     (801) 794-3567
  (801) 253-2249
                                          Roth, David C                                                                      330 E Tabernacle St
                                          2651 W South Jordan Pkwy Ste    Palmer, Kenneth M             Orthodontist         (435) 673-3211
  Ludlow, Mark E                          103                             128 W 900 N Ste A                                  Frei, Daniel K
  2651 W South Jordan Pkwy Ste            (801) 446-1515                  (801) 794-2254           Schouten, John R
                                                                                                   378 E 400 S               111 E 100 S
  101                                     Stark, Cory M                   Perrero, Tyson M                                   (435) 673-6831
  (801) 898-0868                                                                                   (801) 491-9372
                                          3672 W South Jordan Pkwy Ste    312 N Main St                                      Frei, Kyle D
  FOREIGN LANGUAGE(S):                    201                             (801) 794-9684           Warren, Casey
  Spanish                                                                                          485 S Main St Ste 301     111 E 100 S
                                          (801) 260-0400                                                                     (435) 673-6831
                                                                                                   (801) 489-7878




(*) Accepting Established Patients ONLY                                                                                                    Page 13
                                                            Participating Premier Providers

                                          Twiss, Thad B                 Godderidge, Jeremy G        Fisher, William C
      St George                           923 S River Rd Ste 203        1792 W 1700 S Ste 203       5419 S Redwood Rd Ste 2          Orthodontist
                                          (435) 656-5987                (801) 779-6037              (801) 263-6400              Clark, Rdean M
       (Cont'd)                           Valantine, Matthew R          Hansen, Jeffrey             Hicken, Clark               5419 S Redwood Rd Ste 2
                                          10 Diagonal St Ste 201        1747 Heritage Ln Ste B203   5419 S Redwood Rd Ste 2     (801) 263-6400
                                          (435) 673-7373                (801) 525-1725              (801) 263-6400
     General Dentist                      FOREIGN LANGUAGE(S):          Ingram, Clive C             Hickman, William
        (Cont'd)                          Spanish
                                                                                                                                     Periodontist
                                                                        780 S 2000 W Ste F1         5419 S Redwood Rd Ste 2
                                                                        (801) 776-3000              (801) 263-6400              Rizzo, Richard J
  Hall, Phillip C                              Oral Surgeon             Ingram, Richard A           Jensen, Matthew O           3730 W 4700 S
                                                                                                                                (801) 955-1900
  382 S Bluff St                                                        780 S 2000 W Ste F1         2964 W 4700 S Ste 103
  (435) 656-1111                          Bulloch, Scott E              (801) 776-3000              (801) 417-8080
                                          754 S Main St Ste 5
  Hammons, Matthew J                      (435) 652-1445                Ingram, Shad T              Johnson, Robert H                     Tooele
  2107 W Sunset Blvd Ste 101              FOREIGN LANGUAGE(S):          780 S 2000 W Ste F1         5419 S Redwood Rd Ste 2
  (435) 628-6644                                                        (801) 776-3000              (801) 263-6400
                                          Spanish                                                                                    Endodontist
  Hatsis, George C                                                      Nield, Andrew K             Lafeber, Nicholas B
  382 S Bluff St                          Davis, Shawn B                1747 Heritage Ln Ste A1     1909 W 4700 S
                                          393 E Riverside Dr Ste 2B                                                             Coats, John M
  (435) 656-1111                                                        (801) 525-1415              (801) 968-9548              181 W Vine St Ste B
                                          (435) 628-1100
  Henderson, Brandon D                                                  Olson, Aaron M              Lewis, Nate C               (435) 882-8954
  425 E Tabernacle St                     Dudley, Wayne H               1662 S 2000 W Ste A1        1951 W 4700 S Ste 5
                                          10 Diagonal St Ste 204                                                                Madsen, Randall
  (435) 688-1400                                                        (801) 825-2273              (801) 969-1800              181 W Vine St Ste B
                                          (435) 673-1554
  Hilton, Allen E                                                       Patton, Bekki T             Lindgren, Jeremiah M        (435) 882-8954
  736 S 900 E Ste 105                     Mizukawa, John H              1662 S 2000 W Ste A1        5419 S Redwood Rd Ste 2
  (435) 673-2491                          10 Diagonal St Ste 204
  FOREIGN LANGUAGE(S):                    (435) 673-1554
                                                                        (801) 825-2273              (801) 263-8400                 General Dentist
                                                                        Redd, Mark                  Loeser, Michael
  Spanish                                                               1792 W 1700 S Ste 101       5255 S 4015 W Ste 180       Bishop, John L
  Jeppson, Michael C                           Orthodontist             (801) 614-0099              (801) 968-9003              102 W 1180 N Ste 1
                                                                                                                                (435) 882-8600
  1224 S River Rd Ste D                   Beckstrom, Brice W            Roring, John L              McGavin, Scott K
  (435) 628-9600                          1091 N Bluff St Ste 550       1747 Heritage Ln Ste A1     6243 S Redwood Rd Ste 220   Briggs, Graydon J
  Leavitt, Marden Kahle                   (435) 628-6200                (801) 525-1415              (801) 293-8740              263 Country Clb Ste 102
                                                                                                                                (435) 707-3624
  111 E 100 S                             Christian, Wayne              Wilding, Alan D             FOREIGN LANGUAGE(S):
  (435) 673-6831                          330 E Tabernacle St Ste B     1747 Heritage Ln Ste A1     Tahitian                    Bruderer, Steven C
  FOREIGN LANGUAGE(S):                    (435) 628-4422                (801) 525-1415              Meeks, Daniel               1887 Aaron Dr Ste A
  Spanish                                                                                                                       (435) 833-9900
                                          Erickson, Jeff                                            5419 S Redwood Rd Ste 2
  McArthur, John V                        640 E 700 S Ste 301                Orthodontist           (801) 263-6400              Checchio, Joseph M
  133 E Tabernacle St Ste 1               (435) 673-9661                                            Menlove, Benjamin           102 W 1180 N Ste 1
  (435) 628-3288                          Simister, Bradley G           Wasuita, Michael L          5419 S Redwood Rd
                                                                                                                                (435) 882-8600
                                                                        1747 Heritage Ln Ste B203                               Clonts, David J
  Morris, David R                         1054 E Riverside Dr Ste 101   (801) 525-1500              (801) 263-6400
  158 N Main St                           (435) 656-3346                                            Olsen, Phillip              263 Country Clb Ste 103
                                                                        FOREIGN LANGUAGE(S):                                    (435) 882-2850
  (435) 673-4809                          FOREIGN LANGUAGE(S):                                      5419 S Redwood Rd Ste 2
                                                                        German                                                  Eggett, Michael
  Neilson, Chris A                        Spanish                                                   (801) 263-6400
  169 W 2710 South Cir Ste 102            Simister, Jeffrey R                                       Peterson, Dennis W          394 S Main St
  (435) 674-9977                          1054 E Riverside Dr Ste 101
                                                                                 Pediatrics         4745 S 3200 W
                                                                                                                                (435) 882-2331
  Nisson, Kelvin Q                        (435) 656-3346                Hibbert, Steve L            (801) 961-6214              Lawson, Shannon D
  352 E Riverside Dr Ste C3               Simonsen, Randy T             1792 W 1700 S Ste 101       Ramsdell, Christopher       232 S Main St
  (435) 673-1360                                                        (801) 614-0099                                          (435) 882-2755
                                          10 Diagonal St Ste 203                                    M                           McConnell, James
  FOREIGN LANGUAGE(S):                    (435) 628-3773                                            4745 S 3200 W
                                                                                                                                263 Country Clb Ste 103
  German
  Ott, James
                                          Theurer, Michael C              Taylorsville              (801) 961-6214
                                                                                                                                (435) 882-2850
                                          965 E 700 S Ste 101                                       Reading, Tyler              Reese, K.T.
  368 E Riverside Dr Bldg 2               (435) 688-8228                                            5419 S Redwood Rd Ste 2
  (435) 673-3363                                                           General Dentist          (801) 263-6400              215 S 200 E
                                                                                                                                (435) 882-4421
  Plumb, William J                                  Pediatrics          Austad, Thomas N            Reschke, John E             Rockwell, Landon B
  427 W 100 S                                                                                       3730 W 4700 S
  (435) 673-9606                          Scholzen, Jeremy              5419 S Redwood Rd Ste 2
                                                                                                    (801) 955-1900              181 W Vine St
                                          2746 E 850 N                  (801) 263-6400                                          (435) 882-0099
  Prince, Ashton A                        (435) 673-7776                Babcock, David M            Roberson, Jeffrey
  144 W Brigham Rd Ste 15                                                                           5419 S Redwood Rd Ste 2
                                                                                                                                Rockwell, Michael S
                                                                        1909 W 4700 S                                           181 W Vine St
  (435) 656-8003                                                                                    (801) 263-6400
  Robinson, Thomas V
                                               Periodontist             (801) 968-9548                                          (435) 882-0099
                                                                        Blamires, Michael A         Smith, Gregory B            Slater, Rodney J
  10 Diagonal St Ste 104                  Bills, Kenneth B              5419 S Redwood Rd Ste 2     3730 W 4700 S
  (435) 673-5538                          1086 S Main St Ste 102A                                   (801) 955-1900              220 Millpond Ste 107
                                                                        (801) 263-6400                                          (435) 843-5437
  Rowe, Michael                           (435) 628-4867                                            Steele, Richard H
                                                                        Checchio, Joseph M                                      Smith, Hans D
  350 E 600 S Ste 1                                                     6087 S Redwood Rd Ste A     3730 W 4700 S
                                                                                                                                88 E 700 N
  (435) 656-3868
  Staples, Larry O
                                          Stansbury Pk                  (801) 969-7282              (801) 955-1900
                                                                                                    Sundberg, William
                                                                                                                                (435) 843-0225
                                                                        Chidester, Robert J                                     Stobbe, Aaron
  427 W 100 S                                                           5419 S Redwood Rd Ste 2     5419 S Redwood Rd Ste 2
  (435) 673-9606                             General Dentist                                        (801) 263-6400              394 S Main St
                                                                        (801) 263-6400                                          (435) 882-2331
  Stevens, David R                        Dansie, Dan W                 Condie, Curtis              Walton, Troy R              Vernon, Clair
  368 E Riverside Dr Ste 2A               263 Country Clb               5255 S 4015 W Ste 180       4745 S 3200 W
  (435) 673-3363                                                                                    (801) 961-6214              271 S Main St
                                          (435) 882-2850                (801) 968-9003                                          (435) 882-3700
  Stevens, Wade                                                         Dastrup, Kent A             FOREIGN LANGUAGE(S):
                                                                                                                                FOREIGN LANGUAGE(S):
  368 E Riverside Dr Bldg 2                                                                         Spanish
  (435) 673-3363                               Syracuse                 5419 S Redwood Rd Ste 2
                                                                        (801) 263-6400              Warr, Edward
                                                                                                                                Spanish
  Stewart, Russell                                                                                  1909 W 4700 S
                                                                                                                                Wells, Brett R
                                                                        Davis, Ryan B                                           668 N Garden St
  1054 E Riverside Dr Ste 100                General Dentist            1951 W 4700 S Ste 5         (801) 968-9548
  (435) 656-8888                                                                                                                (435) 882-1381
                                                                        (801) 969-1800              Winder, George              FOREIGN LANGUAGE(S):
  Stucki, D. Scott                        Allen, Franklin D             Dean, John E                5419 S Redwood Rd Ste 2
  315 Hilton Dr Ste 1                     1662 S 2000 W Ste A1                                                                  Spanish
                                                                        1951 W 4700 S Ste 5         (801) 263-6400
  (435) 628-5001                          (801) 825-2273
                                                                        (801) 969-1800              Wright, Aaron D             Wells, Michael G
  Taylor, Shane                           Anderson, James                                                                       668 N Garden St
                                                                        Dickerson, Darin            5419 S Redwood Rd Ste 2     (435) 882-1381
  1506 S Silicon Wy Ste 1C                1662 S 2000 W Ste A1                                      (801) 263-6400
                                          (801) 985-1940                5419 S Redwood Rd Ste 2                                 Whitehouse, Scott M
  (435) 688-9990                                                        (801) 263-6400
                                          Argyle, Jaren C                                                                       112 S 100 W
  FOREIGN LANGUAGE(S):
                                                                        Eldredge, Stephen M              Oral Surgeon           (435) 882-7124
  Spanish                                 780 S 2000 W Ste E301
                                                                        3730 W 4700 S
  Tobler, Rex E                           (801) 774-0600                                            Christensen, Bryan S
                                                                        (801) 955-1900              6243 S Redwood Rd Ste 100
  10 Diagonal St Ste 102                  Gardner, Rod T
                                          1792 W 1700 S Ste 101                                     (801) 269-1110
  (435) 628-6026
                                          (801) 614-0099



(*) Accepting Established Patients ONLY                                                                                                      Page 14
                                                            Participating Premier Providers

                                                                      Brown, Jeffrey C                   Roberson, Jeffrey B
         Tooele                                Orthodontist           9251 Redwood Rd                    9217 Redwood Rd Ste B                West Valley
                                          Burke, Brandon G            (801) 566-2155                     (801) 566-1873
        (Cont'd)                          817 W Wiltshire St          Brown, Wayne D                     FOREIGN LANGUAGE(S):                    City
                                          (435) 652-6144              3078 W 7800 S Ste 7B               Spanish
                                                                      (801) 280-1911                     Robison, Brandon J                      Endodontist
       Oral Surgeon                                                   Chadwick, Steven H                 3590 W 9000 S Ste 325
  Partridge, Judd E
                                            Washington                2414 W 7800 S                      (801) 748-1399                     Dana, Reed A
  181 W Vine St                              Terrace                  (801) 566-0629
                                                                      Colton, Brigham
                                                                                                         FOREIGN LANGUAGE(S):
                                                                                                         Spanish
                                                                                                                                            4575 S 5600 W
                                                                                                                                            (801) 955-4400
  (435) 882-8800
                                                                      7613 Jordan Landing Blvd Ste 110   Sampson, Curtis D                  Vanmoorlehem, Ryan
            Pediatrics                       General Dentist          (801) 282-2323                     9225 Redwood Rd Ste A              3730 W 4700 S
                                                                      Elmer, Jonathan R                  (801) 255-8080                     (801) 955-1900
  Burg, Jeff                              Radmall, Val L
                                          5300 S 500 E Ste 10         2414 W 7800 S                      Wagner, Wells W
  220 Millpond Ste 107                    (801) 476-9709              (801) 566-0631                     6973 Cougar Ln Ste D                  General Dentist
  (435) 843-5437                                                      FOREIGN LANGUAGE(S):               (801) 982-0332
  Farnsworth, Russell                     Smyth, Patricia             Spanish                                                               Aarabi, Alexander
                                          5300 S 500 E Ste 1                                             Wahlstrom, Brad A                  3601 Constitution Blvd
  1959 Aaron Dr Ste E                     (801) 476-1234              Erickson, Andrew                   7089 Redwood Rd                    (801) 968-0798
  (435) 882-8800                                                      7611 Jordan Landing Blvd Ste 201   (801) 566-3003
  Knudson, Darin                          Sorensen, Donald W          (801) 280-7001                     FOREIGN LANGUAGE(S):
                                                                                                                                            Barngrover, Ronald D
                                          1508 E Skyline Dr Ste 500                                                                         4085 S 2200 W Ste B
  220 Millpond Ste 107                    (801) 393-2217              Frank, Jonathan R                  Spanish                            (801) 886-1116
  (435) 843-5437                                                      9103 S 1300 W Ste 104              Webb, William H
  Roth, David C                           Tobias, Gerald B            (801) 255-8030
                                                                                                                                            Biddulph, Gregory J
                                          5300 S 500 E Ste 15                                            3855 W 7800 S Ste 150              2792 S 5600 W
  1959 Aaron Dr Ste E                     (801) 479-7600              FOREIGN LANGUAGE(S):               (801) 260-0530                     (801) 969-9669
  (435) 882-8800                                                      Spanish                            Zimmermann, Tom C
                                          FOREIGN LANGUAGE(S):                                                                              Bowman, Todd A
                                          Spanish                     Green, M Brandon                   3855 W 7800 S Ste 150              3444 S 5600 W
     Tremonton                                                        9217 Redwood Rd Ste B
                                                                      (801) 566-1873
                                                                                                         (801) 260-0530                     (801) 964-0444
                                                                                                                                            FOREIGN LANGUAGE(S):
                                              Wellsville              Hart, Brody James                      Oral Surgeon                   Spanish
     General Dentist                                                  9269 Redwood Rd                                                       Boyack, Michael G
                                                                      (801) 566-4153                     Urban, Scott D
  Christensen, Kay B                         General Dentist          Hart, James W                      7611 Jordan Landing Blvd Ste 102   4575 S 5600 W
  718 E Main St                                                                                          (801) 282-5363                     (801) 456-3262
  (435) 257-5678                          Hunt, Tyler J               9269 Redwood Rd                                                       Christensen, Joseph D
                                          51 E Main St                (801) 566-4153
  Gardner, Rod T                          (435) 245-6035                                                      Orthodontist                  3060 S Redwood Rd
  814 E Main St                                                       Holt, Joshua C                                                        (801) 972-0555
  (435) 257-3880                                                      3855 W 7800 S Ste 250              Baird, Brian W                     Demille, Christopher
  Schultz, Bronson                            Wendover                (801) 282-5839
                                                                      FOREIGN LANGUAGE(S):
                                                                                                         8822 Redwood Rd Ste S101
                                                                                                         (801) 280-1722
                                                                                                                                            3550 S 4800 W Ste J
  525 N 400 W                                                                                                                               (801) 969-3025
  (435) 257-7344                                                      Spanish                            Ghiz, Matthew A                    FOREIGN LANGUAGE(S):
  White, Jared R                             General Dentist          Johansen, R Eric                   1577 W 7000 S Ste 200              Spanish
                                          Devries, Bradley E          7611 Jordan Landing Blvd Ste 100   (801) 542-7009
  431 W 600 N                                                                                                                               Dowling, Ryan S
  (435) 257-3210                          399 N Aria Blvd             (801) 563-0699                     Jesperson, Jared C                 3060 S Redwood Rd
  Williams, R Darin                       (435) 665-7525              Johansen, Richard Ryan             1231 W 9000 S Ste D                (801) 972-0555
  718 E Main St                           Hill, Jared D               7613 Jordan Landing Blvd Ste 210   (801) 999-4431                     FOREIGN LANGUAGE(S):
  (435) 257-3631                          399 N Aria Blvd             (801) 280-9595                     Randle, Brian T                    Spanish
                                          (435) 665-2962              Johnson, Brian L                   1231 W 9000 S Ste D
                                                                                                                                            Hassan, Amira A
                                                                      7478 Campus View Dr Ste 200        (801) 999-4431
            Vernal                        Winkel, Kerry M
                                          225 Skyhawk Dr              (801) 282-5112
                                                                                                                                            3280 W 3500 S Ste 3
                                                                                                                                            (801) 969-2121
                                          (435) 665-7730              Johnson, James L                             Pediatrics               Kwant, John W
       Oral Surgeon                                                   8813 Redwood Rd Ste C
                                                                      (801) 255-7800
                                                                                                         Allen, Spencer T                   3725 W 4100 S
  Jessen, G Shane                           West Haven                Johnson, Kirk H
                                                                                                         1577 W 7000 S Ste 200
                                                                                                         (801) 542-7009
                                                                                                                                            (801) 965-2700
                                                                                                                                            Le, Danny
  40 W 100 N                                                          9217 Redwood Rd Ste C
  (435) 781-8211                                                      (801) 255-3579
                                                                                                         Ayre, John                         4066 S 4000 W
  FOREIGN LANGUAGE(S):                       General Dentist          FOREIGN LANGUAGE(S):
                                                                                                         6973 Cougar Ln Ste C               (801) 968-2864
  Spanish                                                                                                (801) 840-4833                     FOREIGN LANGUAGE(S):
                                          Meyer, Louis W              Spanish                                                               Vietnamese/Chinese/Spanish
                                          4645 Midland Dr                                                Johansen, Ryan
                                                                      Kwant, John W                      7613 Jordan Landing Blvd Ste 210   Lloyd, Mark A
       Orthodontist                       (801) 731-5600
                                                                      1227 W 9000 S Ste E                (801) 280-9595                     3521 Market St
  Jackson, Charles B                                                  (801) 677-2739
                                                                                                         Stark, Cory M                      (801) 957-1850
  582 N 1700 W                             West Jordan                Lewis, Jonathan                    1577 W 7000 S Ste 200              Loosli, Bruce
  (435) 781-1234                                                      9103 S 1300 W Ste 104              (801) 571-6751                     3060 S Redwood Rd
                                                                      (801) 255-8030                     FOREIGN LANGUAGE(S):               (801) 972-0555
                                             General Dentist          Maio, Joseph S
        Wanship                           Allan, C Jackson            1227 W 9000 S Ste E
                                                                                                         Spanish                            Mackay, David C
                                                                      (801) 677-2739
                                                                                                         Tew, Michael C                     3550 S 4800 W Ste J
                                          2414 W 7800 S                                                  3855 W 7800 S Ste 200              (801) 969-3025
     General Dentist                      (801) 565-7455              Moore, Peter                       (801) 282-1802                     Mackay, Lyndon
  Judi, Michael J                         Almond, Jeffrey S           7555 Center View Ct Ste 103        FOREIGN LANGUAGE(S):               3550 S 4800 W Ste J
                                          1793 W 9000 S               (801) 748-4151                     Spanish                            (801) 969-3025
  60 S Main St                            (801) 562-2662              Osborne, Bret M
  (435) 336-2657                                                                                                                            Maio, Joseph
                                          Arroyo, Mark S              1847 W 9000 S Ste 103
                                          1847 W 9000 S Ste 202       (801) 255-7243                        West Point                      3725 W 4100 S
                                                                                                                                            (801) 965-2700
    Washington                            (801) 567-9200              Osterhoudt, Darrell L                                                 McGarry, Cody G
                                          FOREIGN LANGUAGE(S):        9217 Redwood Rd Ste C
                                          Spanish                     (801) 568-0172                        General Dentist                 1264 Village Main Dr Unit B
     General Dentist                                                                                                                        (801) 978-1000
                                          Ashton, Ronald G            Petersen, Luke Russel              Oberg, Brandi                      Petersen, David E
  Gibson, Robert L                        9233 Redwood Rd             3078 W 7800 S Ste 7B               466 N Main St Ste 101
                                                                                                         (801) 776-8441                     3725 W 4100 S
  2303 N Coral Canyon Blvd Ste            (801) 566-0971              (801) 280-1911                                                        (801) 965-2700
  202                                     Bangash, Shazmeena          Peterson, John M                   Palmer, R Clair                    Wright, Stephen O
  (435) 652-4284                          1577 W 7000 S Ste 200       3078 W 7800 S Ste 7B               183 N Main St
                                                                                                         (801) 825-1822                     3451 S 5600 W Ste B
  Heideman, Kent A                        (801) 542-7009              (801) 280-1911                                                        (801) 969-1400
  195 W Telegraph St                      Barclay, James J            Powell, David B
  (435) 673-4605                                                      7478 Campus View Dr Ste 202
  Heideman, Richard K
                                          9217 Redwood Rd Ste B
                                          (801) 566-1873              (801) 280-6911
                                                                                                                                                 Orthodontist
  195 W Telegraph St                      Bladen, B Kent              Rigby, Bradley                                                        Chipian, E Terry
  (435) 673-4605                          1662 W 9000 S Ste A         1561 W 7000 S Ste 101                                                 3550 S 4800 W Ste J
                                          (801) 255-6581              (801) 255-7600                                                        (801) 999-4431




(*) Accepting Established Patients ONLY                                                                                                                  Page 15
                                          Participating Premier Providers


   West Valley
   City (Cont'd)
       Orthodontist
         (Cont'd)
  Mortensen, Micah G
  3725 W 4100 S
  (801) 966-6681
  Randle, Brian
  3280 W 3500 S Ste 3
  (801) 999-4431
  Talbot, Travis
  2792 S 5600 W
  (801) 969-9669

         Pediatrics
  Keller, Brady S
  2792 S 5600 W
  (801) 969-9669
  Mandelaris, Jason G
  2792 S 5600 W
  (801) 969-9669
  Rooklidge, Erik
  3540 S 4000 W Ste 440
  (801) 955-5200

   Woods Cross
     General Dentist
  Luedtke, Fred W
  1260 S 500 W
  (801) 294-6174




(*) Accepting Established Patients ONLY                                     Page 16
                                                                                        Alphabetical Index

Aarabi, Alexander ................................. 15          Betz, W Philip ..........................................5    Cannon, Grant B ................................... 11         Davies, Kendell T ................................... 1
Abraham II, James G ............................. 8             Bevan, Curtis C .....................................10       Cannon, Hyrum ...................................... 1         Davila, L John ......................................... 6
Abrams, J Brian ...................................... 5        Biddulph, Gregory J ..............................15          Cantwell, Nicholas .................................. 5        Davis, Ryan B ................................... 5, 14
Adams, A Paul ....................................... 1         Bills, Kenneth B ...............................12, 14        Capener, Randell M ................................ 2          Davis, Shawn B ............................ 2, 3, 14
Adams, Delos C ..................................... 6          Bingham, Legrand ...................................5         Carlson, Monte L ................................ 6, 9         Davis, William C ................................... 13
Adams, Douglas R ................................. 2            Binns, Matthew R ..................................10         Carlson, Tyler B .................................... 12       Day, John W ....................................... 2, 6
Adams, Jody .......................................... 2        Binns, Ralph ............................................5    Carlton, Scott .......................................... 2    Daynes, David R .................................... 8
Adamson, William F ............................... 8            Bishop, John L ......................................14       Carroll, Kelly D ...................................... 10     Daynes, Scott P ...................................... 6
Albertelli, Robert ..................................... 1      Black, Romney R ..................................10          Carter, Gary A .............................. 6, 8, 12         Dean, John E ........................................ 14
Albrecht, John ...................................... 13        Black, W Michael ....................................7        Carter, Justin .......................................... 5    Dedecker, Dennis L ............................ 2, 4
Albrecht, Joshua D ............................... 13           Blackhurst, David ..........................4, 8, 13          Carter, Stephen W .................................. 6         Dedecker, Troy P ................................... 1
Albrecht, Tyler ........................................ 4      Blackhurst, David R ................1, 3, 6, 7, 8             Cerny, William .............................. 1, 7, 12         Dehart, Brent .......................................... 3
Albrecht, Tyler R ............................ 1, 2, 4          Blackhurst, Robert R ...............................8         Chadwick, Steven H ............................. 15            Dehart, Craig .......................................... 5
Alcorn, James ........................................ 4        Blackhurst, Ronald J ...............................5         Chamberlain, Darren D ..................... 8, 13              Demille, Christopher ......................... 6, 15
Allan, C Jackson .................................. 15          Blackhurst, Steven ..................................5        Chandler, Jason G .......................... 2, 4, 7           Demille, Maurice C ................................. 4
Alldredge, D Bryce ............................... 13           Bladen, B Kent ......................................15       Chandler, Nathan E .............................. 12           Denning, Don W ..................................... 4
Allen, Franklin ...................................... 10       Blake, Clinton L .....................................13      Chaston, Reve .......................... 2, 4, 7, 12           Denos, Richard L .................................. 13
Allen, Franklin D ................................... 14        Blake, Heath J .........................................8     Checchio, Joseph M ............................. 14            Devries, Bradley E .......................... 10, 15
Allen, Owen C .................................. 6, 10          Blamires, Michael A ......1, 4, 6, 10, 12, 14                 Cheney, Jess C .................................... 10         Dibble, Kenneth R ................................ 12
Allen, S Todd ........................................ 13       Blanch, Joseph P ....................................5        Chidester, Robert J ... 1, 4, 6, 7, 10, 12, 14                 Dickerson, Darin ....... 1, 4, 6, 7, 10, 12, 14
Allen, Spencer T ............................... 3, 15          Blanchard, Steven T ...............................2          Chikaraishi, Todd .................................. 10        Dickson, R Scott ................................... 10
Allen, Stanton C ..................................... 9        Blanco, David ..........................................6     Child, Paul .............................................. 6   Dillman, Ray E ...................................... 10
Allred, Aaric J ......................................... 3     Bliss, Andrew J .....................................10       Chipian, E Terry ................................ 9, 15        Dobson, Dennis L ................................... 9
Allred, Kirk H .......................................... 7     Blume, Dennis .......................................13       Chisholm, Jon R ................................... 12         Dockstader, Jeremy R .......................... 13
Almond, Jeffrey S ........................... 10, 15            Blume, Dennis J ......................................7       Chisholm, Richard T ............................... 2          Dorius, Kevin S ..................................... 13
Alvord, David L ..................................... 13        Bluth, O Daniel ........................................1     Cho, Denny N ....................................... 10        Douglas, Colton C .................................. 5
Anderson, David M ............................... 12            Bonny, James B ....................................10         Christensen, Aaron A ............................. 7           Dowdle, Daniel R .............................. 9, 12
Anderson, Eric S .................................... 6         Booth, Chad K.........................................9       Christensen, Allen M .............................. 7          Dowling, Ryan S ......................... 7, 10, 15
Anderson, Gregory E ......................... 3, 5              Booth, Gregory A ....................................6        Christensen, Brett K ............................. 13          Downing, Randy ............................... 3, 13
Anderson, James ................................. 14            Booth, Paul .............................................6    Christensen, Bryan S ............................ 14           Downing, Randy N ........... 1, 5, 7, 8, 9, 10
Anderson, James V .............................. 10             Boren, Don R ..............................6, 10, 12          Christensen, Craig M ........................ 9, 12            Draper, Mary F ....................................... 6
Anderson, John A ................................... 1          Borg, Brian D ..........................................9     Christensen, David G ........................... 10            Drury, Scot ........................................... 10
Anderson, John R ............................ 3, 10             Bott, Ryan ...............................................1   Christensen, Devin ................................. 3         Dudley, Wayne H ......................... 2, 9, 14
Anderson, Kenneth R ........................... 10              Bowen, Ronald S ....................................5         Christensen, Joseph ............................... 1          Duke, David L ................................. 10, 12
Anderson, Lowell K ...............................11            Bowman, Todd A ..................................15           Christensen, Joseph D ..... 1, 4, 10, 12, 15                   Dunn, J Michael .................................... 13
Anderson, Paul D ................................... 5          Boyack, Michael G ................................15          Christensen, Kay B ............................... 15          Dyer, Bricanei A ................................... 13
Anderton, Kirk J ...................................... 2       Boyden, Robert D ...................................3         Christensen, Kurt D .......................... 6, 10           Earl, Darren B ....................................... 13
Aoki, Alan ............................................. 10     Brain, Patrick R .....................................12      Christensen, Louis R ............................ 13           Easton, R Jeff ....................................... 12
Arbuckle, Jeffrey G ................................. 2         Braithwaite, Larry A .................................9       Christensen, Michael T ........................... 1           Eaton, Jason W ...................................... 4
Arbuckle, Kent K .................................... 2         Braithwaite, Randy C ..............1, 3, 5, 7, 8              Christensen, Richard D ........................ 10             Edmunds, Eli ........................................ 10
Argyle, Jaren C .................................... 14         Braithwaite, Steven R .............................1          Christensen, Steven E .......................... 11            Egan, Kelly C .......................................... 4
Arkoudas, Wade ..................................... 4          Brauer, Jack ..........................................10     Christensen, Ted L ................................. 9         Egbert, Gregory W ............................... 10
Arroyo, Mark S ..................................... 15         Bridge, Rod .............................................9    Christian, Wayne .................................. 14         Eggett, Michael ............................... 10, 14
Arthur, David K ....................................... 7       Briggs, Graydon J .............................6, 14          Christiansen, Craig A .............................. 7         Elder, Scott D ....................................... 10
Arthur, Douglas K ................................... 7         Briggs, Shaun S ....................................13        Chudleigh, Brian ..................................... 5       Eldredge, Stephen .................................. 7
Asay, Daniel W ..................................... 13         Brimhall, Charles .....................................9      Church, Craig S ...................................... 2       Eldredge, Stephen M ............................ 14
Asay, Gaylen .......................................... 2       Brimley, Curtis J ......................................9     Clark, Albert B ........................................ 9     Eliason, G M ........................................... 6
Ashman, Tyler ........................................ 9        Brinkerhoff, Matthew S ........................1, 9           Clark, Herald R ..................................... 10       Ellingson, Daniel ................................... 12
Ashton, Ronald G ................................. 15           Broadbent, Michael .................................4         Clark, Kyle W .......................................... 4     Ellis II, Richard L .................................. 10
Asper, Mark W ..................................... 10          Broadbent, Michael W .............................7           Clark, Rdean M ................................. 2, 14         Ellis III, Richard L ................................. 10
Aste, R ................................................... 5   Broadwater, Paul M ..........................9, 12            Clegg, David T ........................................ 3      Ellis, James W ........................................ 6
Atwood, Michael R ............................... 10            Brockbank, Wells S ...............................13          Clegg, Richard ...................................... 10       Ellis, Jeremy W ....................................... 5
Atwood, Richard M ............................... 13            Bromley, J Jacob ....................................9        Clonts, David J ..................................... 14       Elmer, Jonathan R ................................ 15
Austad, Thomas N ... 1, 4, 6, 7, 10, 12, 14                     Brooks, Leslie Graff ................................5        Cloward, Aaron D ................................. 13          Ence, Eric J .......................................... 13
Austin, Blaine D .....................................11        Brown, Garry M .......................................7       Coats, John M ................................ 10, 14          Ence, I Lee ........................................... 13
Ayre, John ............................................ 15      Brown, Gregory H ...................................2         Cold, Scott P ......................................... 10     Ence, James N ..................................... 13
Babcock, David ................................ 4, 13           Brown, Jeffrey C ...................................15        Cole, Daren C ..................................... 3, 6       Ence, Mark R ........................................ 13
Babcock, David M ...................... 3, 13, 14               Brown, Jennifer .......................................4      Coleman, C Ray ................................... 10          Ence, Nathan ........................................ 13
Baggaley, Todd J ............................... 6, 8           Brown, Jerry V ........................................5      Coleman, Jonathan F ............................. 8            Endrizzi, Mark T ............................... 3, 12
Bailey, James I ....................................... 8       Brown, Layne C ....................................10         Collman, Marc ........................................ 6       Erekson, David G ................................... 1
Bailey, Ryan H ....................................... 8        Brown, Michael Rory .............................13           Colton, Brigham ................................ 8, 15         Erickson, Andrew ................................. 15
Baird, Brian W ............................ 7, 12, 15           Brown, Scott H ........................................2      Condie, Brian A ...................................... 8       Erickson, Jeff ........................................ 14
Baird, Daniel R ................................. 1, 10         Brown, Shawn H .....................................2         Condie, Curtis ....................................... 14      Erickson, Louis A .................................... 9
Baird, Robert M ................................ 8, 13          Brown, Wayne D ...............................9, 15           Connolly, Dean B .................................. 10         Erickson, Verd J ................................... 13
Baker, Susan M .................................... 13          Bruderer, Steven C ...............................14          Connolly, Jeffrey D ............................... 10         Evershed, Morgan P ......................... 8, 13
Baldwin, Cade G .................................... 3          Buchanan, Julie ....................................13        Cook, Michael J .................................... 12        Facer, Steven R ................................. 2, 9
Baldwin, Kenneth J ...............................11            Buhler, Cameron S ...............................13           Cope, Benjamin D .................................. 3          Fackrell, Craig D ..................................... 2
Ball, Douglas .......................................... 7      Buhler, Forrest S ...................................13       Corry, Scott W ........................................ 3      Faddis, Kelly A ....................................... 3
Bangash, Shazmeena .................... 12, 15                  Bulloch, Scott E .....................................14      Cottle, Douglas G ................................... 6        Faerber, David .................................. 1, 13
Banks, Steven H .................................. 13           Burdett, Daniel S .....................................6      Cottrell, Courtland G ............................. 10         Faerber, David E .................. 1, 3, 7, 8, 12
Barber, Norman C .................................. 5           Burg, Jeff ...........................................2, 15   Cox, Dan M ........................................... 13      Fairbanks, Jon C .............................. 3, 13
Barclay, James J .............................. 6, 15           Burg, Jeffrey S ........................6, 8, 10, 12          Cox, Kevin G .......................................... 2      Farley, John M ........................................ 8
Barnes, Richard ................................... 10          Burke, Brandon G .........................3, 4, 15            Cox, Val S ............................................... 6   Farnsworth, Russell ........................ 13, 15
Barngrover, Ronald D .......................... 15              Burns, Noel E ........................................10      Craven, Scott H ...................................... 6       Farris, Dustin J ..................................... 10
Barrick, Michael ...................................... 2       Burns, Walter R .....................................10       Crawford, Gary L ................................ 8, 9         Faulkner, Davin ...................................... 2
Barrick, Robert L .................................... 2        Burton, Christopher .................................8        Crawford, J Chris .................................... 7       Favero, Jeffrey K .................................... 6
Barry, David J ......................................... 7      Burton, Christopher C ...........................12           Crook, Adon E ...................................... 10        Feller, Paul ............................................. 8
Barry, Mark T ......................................... 7       Butler, Brent S .........................................2    Crookston, Michael ........................... 3, 10           Felt, Jeremy .......................................... 10
Barton, Jason G ............................... 4, 10           Butler, Todd M ........................................9      Crowther, Glade R .............................. 2, 5          Fenton, Andrew R ............................ 8, 12
Bateman, Adam R ............................ 5, 13              Butterfield, Brad A ...................................6      Crowther, Lance D .................................. 5         Ferrell, D. Terry ...................................... 5
Bateman, Blaine S ................................. 4           Bye, Walter Landon ..............................10           Crowther, Theran .................................... 5        Findley, Gary L ..................................... 10
Bateman, Joshua M ............................... 1             Cahoon, Kevin S .....................................8        Crowton, Michael L ................................. 6         Finlinson, Clark R ................................... 4
Bateman, Ryan V ................................... 2           Call, Brian D ............................................3   Curtis, C Blaine ....................................... 3     Fischer, David V ..................................... 3
Baugh, Alan C .................................... 6, 9         Call, Devon R ..........................................9     Curtis, Cabot ............................... 1, 12, 13        Fisher, William C .......... 1, 4, 7, 10, 12, 14
Bawden, Hal ......................................... 12        Call, Nathan D .........................................6     Curtis, Lindsay S .................................... 6       Flath, Robert K ....................................... 8
Beckstrand, J Bruce ............................... 3           Call, R Reed ............................................9    Curtis, Raymond J .................................. 5         Flick, Steven K ....................................... 9
Beckstrom, Brice W .............................. 14            Callahan, Duane D ................................12          Dacquel Clem, Joy ................................. 4          Flint, Robert L ....................................3, 11
Bench, Steven ........................................ 3        Callan, Mark James ..............................10           Daines, Clifford ....................................... 6     Flynn, David L ........................................ 1
Benson, Brady E .................................... 2          Callister, J Craig ......................................8    Daines, Howard R .................................. 2          Flynn, Robert M ...................................... 4
Benson, Paul D .................................4, 11           Callister, John D ......................................8     Dana, Reed A ....................................... 15        Fonnesbeck, Vance B ............................ 8
Benzon, Josef ........................................ 9        Campbell, Galen ...................................10         Dansie, Dan W ................. 3, 9, 10, 13, 14               Ford, Jonathan G ................................... 6
Benzon, Josef A ................................... 12          Campbell, Jonathan G ..........................10             Dastrup, Kent A ............................ 2, 4, 14          Ford, Kraig R .......................................... 3
Berg, Christopher ................................... 8         Canfield, Steven M ................................10         Dastrup, N Jared .................................... 3        Ford, T Michael ...................................... 9
Berg, Gerald R ....................................... 5        Cannon, David H ...................................10         Davidson, Collin .................................... 10       Francis, Karl M ..................................... 13
Bess, John Shea .................................. 13           Cannon, David S ...................................10         Davies, D Alan ........................................ 2      Francis, Richard W ............................... 13



                                                                                                                                                                                                                              Page 17
                                                                                       Alphabetical Index

Frandsen, Brian L ................................... 7       Hassan, Amira A ...................................15           Johansen, Stephen ............................... 12           Luke, Spencer D ....................................11
Frandsen, Joshua R ............................. 10           Hatch, Jeremy D .....................................4          Johnson, Brian L ................................... 15        Lund, James D ..................................... 13
Frandsen, Kelly M .................................. 3        Hatsis, George C ............................10, 14             Johnson, Christopher S .......................... 3            Lund, Trace M ........................................ 9
Frank, Jonathan R ................................ 15         Haymond, Creed S ...........................3, 12               Johnson, David ....................................... 9       Lundberg, Brent Dee .............................. 5
Frei, Daniel K ....................................... 13     Haynie, Michael ......................................5         Johnson, James L ................................ 15           Lundeen, Kelly J ..................................... 4
Frei, Kyle D .......................................... 13    Healey, Scott M .......................................5        Johnson, Jeffrey D .................................. 9        Lyman, Scott M .................................... 13
French, Jared T ...................................... 4      Healy, James R .......................................6         Johnson, Kent N ..................................... 3        Macdonald, David ............................. 1, 12
French, Ronald A ................................... 1        Heaton, Kenneth W .................................4            Johnson, Kirk H .................................... 15        Macdonald, Paul R ................................. 1
Froerer, Jacob Scott ............................. 10         Heideman, Kent A .................................15            Johnson, Lynn S ..................................... 5        Mackay, David C .............................. 6, 15
Frost, Ron A ........................................... 4    Heideman, Richard K ............................15              Johnson, Nathan .................................... 8         Mackay, Lyndon ............................... 6, 15
Gardner, Darren W ................................. 9         Henderson, Brandon D .....................2, 14                 Johnson, Richard S ................................ 9          Mackay, Matthew H ................................ 1
Gardner, Jonathan B .............................. 9          Hendrickson, Heath ................................9            Johnson, Robert ................. 1, 4, 6, 11, 12              Mackley, Mark D ................................. 2, 7
Gardner, Rod T .............................. 14, 15          Hendrickson, R Heath .............1, 4, 5, 7, 8                 Johnson, Robert H .................... 1, 6, 7, 14             Mackley, Paul ..................................... 5, 7
Gardner, Timothy A ............................ 4, 5          Henrickson, R Heath .............................13             Jolley, Chris M ........................................ 8     Mackley, Paul A ...................................... 2
Garner, L Ray ......................................... 6     Hess, Jason G ........................................2         Jones, Aaron H ....................................... 8       Madsen, Dennis R .................................. 7
Garr, Benjamin L .................................... 6       Hesselgesser, Lamont E .........................8               Jones, Ammon ........................................ 8        Madsen, Randall .................... 6, 9, 10, 14
Geddes, Derald W .................................. 6         Heward, Timothy .....................................9          Jones, Brian R ........................................ 9      Magleby, Bruce L ................................... 6
Geddes, Mark C ..................................... 6        Heward, Timothy S .................................9            Jones, Drew .......................................... 11      Maio, Joseph ........................................ 15
Gerrard, Devin Mason ............................ 1           Hibbert, Steve L ....................................14         Jones, M Brandon .................................. 4          Maio, Joseph S ................................. 9, 15
Ghiz, Matthew ...................................... 13       Hibler, G Allen .........................................1      Jones, Nelson L ...................................... 6       Malan, Matthew ...................................... 7
Ghiz, Matthew A ............................... 3, 15         Hicken, Clark .........................6, 10, 12, 14            Jorgensen, Norman G ............................ 8             Malan, Max J .......................................... 7
Gibson, Robert L .................................. 15        Hicken, Clark B ...............................1, 4, 7          Judi, Michael J ...................................... 15      Mandelaris, Jason G .................... 2, 5, 16
Gilbert, J Bryan ...................................... 6     Hickman, William ........................1, 12, 14              Karren, Gary R ....................................... 6       Mangrum, Kelly A ..................................11
Gilstrap, Benjamin L ............................. 12         Hill, Jared D ......................................7, 15       Keefe, Chris W ..................................... 13        Mansell, Kevin ...................................... 12
Glassett, Nelson D ................................. 3        Hill, Jerel D ..............................................7   Keller, Brady S ...................................... 16      Marberger, Adam ..................................11
Gleave, Barton T .................................. 10        Hillam, R Barry ........................................9       Kelley, Randall J ..................................... 6      Markham, Kevin R .................................. 9
Godderidge, Bruce H ........................... 13            Hills, P Bradley ........................................7      Kim, Steve ............................................ 12     Marsh, Justin S ....................................... 8
Godderidge, Jeremy G ......................... 14             Hilmo, Justin .........................................13       Kimball, Don H ...................................... 11       Marshall, Kyle R ................................... 13
Goeckeritz, Chad ............................. 3, 10          Hilton, Allen E .......................................14       King, David R .......................................... 3     Martin, Eric E .................................. 3, 8, 9
Goldberg, Aaron S ............................... 10          Hinton, April ............................................1     Knight, Michiel R ................................... 10       Martinez, Paul B ..................................... 8
Goodman, Chris E .................................. 6         Hodge, Jason ..........................................6        Knight, Samuel D .................................... 6        Marz, Kenneth J ..................................... 5
Goodwin, Dustin V ................................. 3         Holman, Brian G ...............................2, 12            Knudson, Darin ............................. 2, 6, 15          Masson, Daniel L .................................. 12
Goodwine, Brian ..................................... 5       Holman, R Gayle ...........................2, 5, 12             Knudson, Darin R ................... 6, 8, 11, 12              Matheson, Michael K .............................11
Gordon, David P ..................................... 5       Holmberg II, William R ..........................10             Knudson, Peter C ....................... 2, 12, 13             Matthews, Jeremy B ............................. 12
Gordon, David R .................................... 5        Holmberg, William R ............................. 11            Kolon, Jonathan ...................................... 8       Mattinson, Craig J .................................. 1
Goupios, Peter G ................................... 2        Holt, Joshua C ......................................15         Kunzler, Richard C ................................. 9         Mattinson, Keith S .................................. 8
Goupios, Robert ..................................... 2       Holt, Nathan C ........................................3        Kwant, John W ................................. 9, 15          Maughan Jr, Kenneth C ......................... 7
Gray, Eric T ............................................ 4   Homer, Brian L ......................................12         Lafeber, Nicholas B .................. 11, 12, 14              Maughan, Willard W ......................6, 7, 11
Greaves, Jesse N ................................. 10         Hopkin, Joe T ..........................................5       Lambert, Jeffrey ...................................... 4      Mauseth, Spencer .................................. 8
Green, John ........................................... 7     Hopkins, Jess C ......................................5         Lapine, John Paul ................................. 11         Maymi, Gerardo .................................... 13
Green, M Brandon ................................ 15          Hopkins, Paul D ................................8, 10           Larsen, Alexander B ............................... 7          McArthur, John V .................................. 14
Greenhalgh, Jennifer ........................ 1, 13           Howard, Hugh J ......................................4          Larsen, Clyde ......................................... 3      McBee, William L .......................... 8, 9, 12
Greenhalgh, Jon ..................................... 6       Howarth, Joel L .......................................9        Larsen, Clyde S ...................................... 8       McConkie, Daniel ................................... 7
Greenhalgh, Jonathan .......................... 10            Howarth, John H ................................... 11          Larsen, Elmer G ..................................... 5        McConnell, James ................................ 14
Greenwood, Brandon D ................... 1, 12                Howe, Chad V .......................................10          Larsen, Gregory P ................................ 12          McGarry, Cody G ............................. 7, 15
Greenwood, Dale M ......................... 1, 12             Howe, Douglas H .................................. 11           Larsen, James D .................................... 4         McGavin, Scott K .................................. 14
Griffeth, Matthew M ................................ 8        Howell, Bruce ..........................................8       Larsen, Paul C .................................... 1, 3       McGowan, David J ................................. 6
Griffiths, Benjamin M .............................. 5        Hoyal, James C .......................................7         Larson, Anthony L .............................. 5, 9          McIff, Steven F ....................................... 8
Groll, Shawn R ................................... 4, 9       Huang, Adrian G .....................................9          Larson, Eric A ....................................... 11      McInnes, Matthew .................. 1, 4, 5, 7, 8
Guenter, Jeremy .................................. 10         Hudson, Sascha ............................1, 7, 12             Larson, Ernest M .................................... 3        McInnes, Matthew S ............................. 13
Guenter, R Jeremy ................................. 9         Huffaker, David M ...................................2          Larson, Matthew B .......................... 11, 12            McLachlan, Adam P ..............................11
Guenter, Robert J ................................... 9       Huffaker, Ford B ......................................2        Larson, Scott A ..................................... 11       McNaughtan, Benjamin J ....................... 3
Gunn, Ryan S ......................................... 2      Huffaker, Todd B .....................................2         Latham, David B ..................................... 5        Meden, Walter ...................................... 13
Gunnell, Lance F .................................... 5       Hughes, Richard ...................................12           Lawson, Shannon D ............................. 14             Meek, Daniel .......................................... 7
Gunnerson, K Cheyn .............................. 8           Hulet, Gary M ..........................................9       Le, Danny ............................................. 15     Meeks, Daniel ................1, 4, 7, 11, 12, 14
Hadfield, Benjamin ........................... 6, 10          Hunt, Tyler J ..........................................15      Leavitt, Marden Kahle ........................... 14           Meier, Joseph V ....................................11
Hadfield, Randal L .................................. 5       Huntington, Gavin .................................12           Lee, Adam N ..................................... 8, 13        Menlove, Benjamin ........1, 4, 7, 11, 12, 14
Hadley, Dale C ..................................... 13       Huntington, Nathan S..............................6             Lee, David G ........................................... 9     Menlove, Benjamin R ........................2, 11
Hall, Aaron C .......................................... 3    Hutchings, Brent R ................................ 11          Lee, Jung ................................................ 7   Merrill, David R ....................................... 7
Hall, Phillip C ........................................ 14   Hutchings, Michael B ............................ 11            Lee, Todd P ............................................ 9     Meyer, Louis W .................................... 15
Hamblin, Robert L .................................. 9        Ingram, Clive C .....................................14         Lemon, James N .................................. 10           Meyers, John .........................................11
Hamilton, Ryan ....................................... 9      Ingram, Richard A .................................14           Lewis, Jonathan .................................... 15        Middleton, John H .................................. 6
Hamilton, Sanford ................................ 10         Ingram, Shad T .....................................14          Lewis, Kent S ........................................ 11      Miller, David W ..................................... 13
Hamilton, Shawn M .............................. 10           Iroz, David E ...........................................9      Lewis, Nate C ....................................... 14       Miller, Gerald O .................................. 3, 5
Hammond, Keith D ................................. 5          Isaacson, Brian E ....................................8         Leydsman, Steve R ................................ 4           Miller, John D ....................................... 13
Hammons, Matthew J .......................... 14              Isaacson, Wm Edward ............................8               Liddiard, K John .................................... 13       Miller, Mark T ...................................... 4, 6
Handy, Ken B ......................................... 6      Isakson, Brent J ....................................10         Liddle, Joseph D ..................................... 1       Miller, Matthew ....................................... 7
Hanna, Paul D ...................................... 10       Israelsen, L Douglas .....................2, 8, 13              Liddle, Stephen B ................................. 11         Miner, Alan C ........................................ 13
Hansen, Clayton M ................................. 1         Iverson, Clint ...........................................6     Lindgren, Jeremiah ................................. 4         Mizukawa, John H ........................ 2, 9, 14
Hansen, David K .................................. 10         Iverson, Jeffrey A ..............................4, 12          Lindgren, Jeremiah M ... 1, 6, 7, 11, 12, 14                   Moffat, Ryan ........................................... 3
Hansen, Heather D ................................ 6          Iverson, Vern Q .......................................3        Lindsay, Stuart .................................. 1, 13       Molen, Kenneth ...................................... 7
Hansen, Jeffrey .................................... 14       Jackson, Brett R ......................................4        Lindsay, Stuart K .................................. 12        Moody, Daryn C ..................................... 9
Hansen, Kent B .................................... 13        Jackson, Charles B .........................12, 15              Link, Devin M ........................................ 11      Moore, Nathan S .................................. 12
Hanson, Dorr W ..................................... 3        Jackson, David E ..................................12           Linsley, Kent ........................................... 7    Moore, Peter ......................................... 15
Hanson, Eric ........................................... 3    Jackson, Jonathan ................................13            Liston, Todd C ................................ 2, 4, 7        Moore, Scott E ...................................... 10
Hanson, Nathan ..................................... 9        Jackson, Jonathan D ..............................8             Liu, Lloyd K ............................................. 3   Morgan, Christopher T ........................... 4
Hanzon, Jeff ......................................... 10     Jackson, M Blane ....................................8          Lloyd, Jon W ........................................... 9     Morgan, Jaimee A .................................. 5
Harding, Roger K ............................... 1, 9         Jarman, Dean .........................................3         Lloyd, Mark A ........................................ 15      Morgan, Kyle S ....................................... 4
Harmon, Kyle K ...................................... 4       Jeffery, Darrin R ......................................9       Lloyd, Mv Sheffield ................................. 5        Morgan, Stephen S ................................ 4
Harris, Chad M ..................................... 13       Jensen, Brandon C .................................3            Lobrot, Reed D ....................................... 3       Morris, David R ..................................... 14
Harris, Daniel L .................................... 13      Jensen, Dan B ........................................4         Loeser, Michael ...................... 1, 7, 12, 14            Morris, Derek R .................................... 13
Harris, Frank O ....................................... 5     Jensen, Jay D ....................................... 11        Loftus, David O ....................................... 6      Morris, Shad L ........................................ 2
Harris, Mark E ........................................ 6     Jensen, Matthew O ...............................14             Loosli, Bruce ......................................... 15     Morrison, Jeffrey S ............................. 4, 7
Harris, Michael D ................................ 8, 9       Jensen, S Wayne ....................................5           Lord, Brian J ......................................... 13     Mortensen, Micah G ......................... 4, 16
Harris, Paul E ......................................... 5    Jensen, Steven .....................................12          Lorscheider, M Sean .............................. 2           Mortenson, Celeste C ............................. 5
Hart, Body James ................................... 5        Jensen, Tony M ......................................3          Lorscheider, Michael H ........................... 9           Moss, Douglas ........................................ 3
Hart, Brody ........................................... 13    Jenson, Richard H ..................................8           Losee, Blair I ........................................... 5   Moyes, Brett K ........................................ 7
Hart, Brody James ............... 1, 3, 7, 8, 15              Jeppson, Michael C ..............................14             Lowe, Bret K ........................................... 8     Moyes, Laurence K ................................ 7
Hart, James W ..................................... 15        Jesperson, Jared C ...........................8, 15             Lowe, Steven B .................................... 11         Muir, Eric B ............................................. 1
Hart, Ryan R .......................................... 3     Jessen, G Shane ................2, 5, 7, 12, 15                 Lucas, Sean P ...................................... 11        Mund, Kody C ......................................... 7
Hartvigsen, Darin ................................. 10        Jessen, Shane G .................................. 11           Lucero, Robert M .................................... 3        Murdock, Bruce T ................................... 1
Hartvigsen, James L .............................. 1          Jindal, Harini ...........................................8     Ludlow, Jeremy L ................................... 2         Murdock, Hal D ....................................... 1
Harward, Brian S .................................... 2       Johansen, R Eric ...................................15          Ludlow, Mark E ..................................... 13        Murdock, Mark B .................................... 2
Haslam, Jeffrey R ................................... 6       Johansen, Richard Ryan .......................15                Ludlow, Thomas H ................................ 11           Muse, Gregrey L ....................................11
Hassan, Amira ...................................... 13       Johansen, Ryan ....................................15           Luedtke, Fred W ................................... 16         Myers, Delmont G .................................. 1



                                                                                                                                                                                                                              Page 18
                                                                                        Alphabetical Index

Myers, John .......................................... 13       Phillips, Shane L ...................................12       Segura, Stuart D ....................... 5, 6, 8, 12          Taylor, Michelle L ................................... 5
Myers, John W ............... 1, 3, 5, 6, 7, 8, 9               Pickett, Victor O .................................... 11     Sergakis, William M .............................. 11         Taylor, Robert R ..................................... 7
Myers, Joseph W ................................... 2           Pierson, Blaine R ....................................4       Shaw, Jerry L .......................................... 7    Taylor, Shane ....................................... 14
Nance, Brady M ..................................... 3          Pincock, David W ....................................7        Shaw, Tyler ............................................. 7   Tew, Michael C ............................... 12, 15
Nance, David K .................................... 13          Pinegar, Steven C ............................. 9, 11         Shields, Jay G ...................................... 11      Theurer, Craig B ....................................11
Naylor, Paul .......................................... 10      Pitt, Bruce G ............................................2   Shoff, Carl C ........................................... 1   Theurer, Michael C ............................... 14
Neeley, J. Christian .......................... 8, 10           Pitt, Jason M ...........................................2    Shurtleff, William J .................................. 7     Theurer, Scott L ...................................... 5
Neil, Rachelle ......................................... 4      Pitt, Jerem M ...........................................2    Sigrist, Tom .......................................... 12    Thomas, Stuart M ................................... 4
Neil, Scott James ................................... 4         Plumb, William J ...................................14        Simister, Bradley G ........................... 4, 14         Thompson, Connor L .............................. 3
Neilson, Chris A ................................... 14         Pollock, Hal G ....................................... 11     Simister, Jeffrey R ............................ 4, 14        Thompson, Leland R .............................. 3
Nelson, Daniel K .................................... 2         Pond, W Henry ...................................... 11       Simkins, Boyd ......................................... 6     Thompson, Rudy ...................................11
Nelson, Mark L ....................................... 2        Pope, Marcus R ................................ 4, 11         Simonsen, Randy T .............................. 14           Thompson, Wade D ............................... 8
Nelson, Raechel A ................................. 9           Pope, Steven R ..................................... 11       Slater, Rodney J ............... 6, 8, 11, 12, 14             Thompson, Wesley B ............................. 3
Neville, Jeff ............................................. 4   Porter, Bryan D .......................................6      Smart, J. Richard .................................... 4      Thornley, Mark J ..................................... 5
Newey, Mark .......................................... 2        Porter, Paul M ....................................... 11     Smith, Andrew M .................................... 6        Thorup, Robert R ...................................11
Nguyen Tran, Hanhngan H ...................11                   Porter, R Von ........................................ 11     Smith, Brian W ...................................... 11      Thunell, Daniel ................................... 1, 4
Nicholls, David W ............................. 8, 12           Powell, David B .....................................15       Smith, Craig T ....................................... 11     Tidwell, Anthony C ................................11
Nichols, Mark A ...................................... 7        Powell, Leland .........................................4     Smith, Darrel G ....................................... 3     Tidwell, Eric I .......................................... 9
Nield, Andrew K ................................... 14          Presley, Stanley K...................................5        Smith, David O ..................................... 11       Tillmann, Ruediger ................................11
Nielsen, Paul A ....................................... 9       Price, Christopher J ................................9        Smith, Douglas ....................................... 5      Tobias, Gerald B .................................. 15
Nilson, Scott B ........................................ 7      Price, Cory D .................................1, 4, 12       Smith, G Trevor ...................................... 8      Tobias, Justin S ...................................... 7
Nisson, Kelvin Q ................................... 14         Priebe, Brandon M ..............................5, 9          Smith, Gregory ............... 1, 2, 4, 7, 11, 12             Tobler, Bret A ......................................... 5
Noh, Bong K ........................................... 9       Prince, Ashton A ...................................14        Smith, Gregory B .................................. 14        Tobler, Eric A .......................................... 5
Noorda, Matthew L ................................. 3           Prince, David B .......................................7      Smith, Hans D ...................................... 14       Tobler, Nathan B .................................... 5
Nord, Scott C ...................................... 3, 8       Probst, Kent T .........................................3     Smith, J Joshua .................................... 11       Tobler, Rex E ....................................... 14
Norris, Kipton J ....................................... 7      Proctor, Craig R .................................... 11      Smith, Michael T ................................... 11       Todd, Douglas M ...................................11
Oberg, Brandi ....................................... 15        Pugh, B Charles ......................................9       Smith, Nathan E ............................... 1, 12         Toone, Kent J ......................................... 2
Odonoghue, Bruce J .............................11              Pulsipher, Richard J ..........................9, 10          Smith, Ronald T ...................................... 9      Topham, David Scott .............................11
Ogilvie, Ralph ......................................... 3      Radmall, Val L .......................................15      Smith, Steven D .................................... 13       Torgeson, Gerald L ................................ 6
Oldroyd, Alexander ...............................11            Rallison, M W ..........................................7     Smoot, David J ................................. 6, 13        Torghele, Jeffrey J .................................. 7
Oldroyd, Roger J .............. 1, 3, 5, 8, 9, 10               Ramsdell, Christopher M ............ 2, 11, 14                Smyth, Chester K ................................... 2        Tracy, Scott A ......................................... 1
Oliverson, Sean M .................................. 7          Randall, Gregory J ................................12         Smyth, Patricia ..................................... 15      Trapnell, Christopher J ..................... 8, 13
Olsen, Brady J ........................................ 1       Randle, Brian ....................................8, 16       Snow, Harold .......................................... 5     Trapnell, Gregory J ........................... 8, 13
Olsen, Brian F .................................... 1, 5        Randle, Brian T .....................9, 10, 12, 15            Snyder, Matthew G ............................... 11          Tribe, Michael L ...................................... 7
Olsen, Phillip .................1, 4, 7, 11, 12, 14             Rasmussen, Rochelle .............................7            Soelberg, Steven B ................................. 4        Troili, Dean ........................................... 13
Olsen, Phillip P ....................................... 1      Reading, Tyler............... 1, 4, 7, 11, 12, 14             Sonnenberg, Brent C ............................ 12           Trotter, Howard A ................................... 2
Olson, Aaron M ................................ 2, 14           Reber, Richard E .................................. 11        Sonntag, Keith ........................................ 8     Ttroili, Dean C ...................................... 13
Olson, Andrew C .................................... 5          Redd, Jay D ..........................................12      Sonntag, Keith D .................................. 10        Twiss, Thad B ....................................... 14
Olson, C Brook ..................................... 10         Redd, Mark ...........................................14      Sorensen, Bret J ................................... 13       Ulm, Sean ............................................... 5
Olson, Craige J .................................5, 11          Reese, K.T. ...........................................14     Sorensen, David J ................................ 13         Updike, Spencer T .............................6, 11
Olson, Glen S ......................................... 6       Reid, Bruce H ........................................ 11     Sorensen, Donald W ............................ 15            Urban, Scott D .................................. 9, 15
Olson, Mark A ........................................ 8        Reschke, John ................ 1, 2, 4, 7, 11, 12             Sorensen, Eric J ..................................... 5      Valantine, Matthew R ........................... 14
Oman, Gregory G ................................... 1           Reschke, John E ...................................14         Sorensen, James .................................... 2        Van Alfen, Craig ....................................11
Orme, Thomas R ...................................11            Richards, Bruce B ...................................1        Sorensen, Shannon W ........................... 2             Vanmoorlehem, Ryan ..................... 13, 15
Ormsby, Daniel W .................................. 6           Richards, Robert S ................................10         Sorensen, Steven ................................. 13         Vernon, Andrew M .................... 2, 4, 6, 12
Osborne, Bret M ................................... 15          Richardson, Jared L ................................4         Sorensen, Steven E ................................ 4         Vernon, Clair ........................................ 14
Osmond, Steven W ................................ 9             Richey, Samuel .......................................9       Sorensen, W Thomas ........................... 13             Viehweg, Tate ........................................ 5
Osofsky, Stuart W .................................. 3          Rigby, Bradley .......................................15      Sorenson, Barry K ................................ 10         Voorhees, I Darrell ................................11
Osterhoudt, Darrell L ............................ 15           Ririe, Craig M ..........................................9    Sorenson, Terry R .............................. 5, 9         Vreeken, Joseph ................................ 5, 6
Ostheller, Joseph ................................... 5         Rizzo, Richard J ..........................8, 12, 14          Spainhower, David ................................. 4         Wade, Glen L ....................................... 10
Ott, James ............................................ 14      Roberson, Jeffrey ...... 1, 2, 4, 7, 11, 12, 14               Spangler, Seth N .................................... 3       Wagner, Spencer B ................................ 9
Otto, Stephan W ....................................11          Roberson, Jeffrey B ..............................15          Sperry, Jeffrey S ................................... 11      Wagner, Wells W .................................. 15
Owens, Robert W ................................. 12            Roberts, Greg A ..................................6, 7        Sperry, Steven M .................................. 11        Wahlstrom, Brad A ............................... 15
Pack, Leland W ...................................... 4         Roberts, Kim G ............................. 1, 7, 11         Staples, Larry O .................................... 14      Waldron, Ryder ...................................... 2
Packard, Jonathan D ............................ 10             Robins, Christopher ................................2         Stark, Cory M .............................. 3, 13, 15        Walker, Bradley S ....................1, 7, 11, 12
Packer, Barlow L .................................... 5         Robins, Merien L .....................................8       Stark, John D ........................................ 13     Walton, Troy R ........................2, 9, 11, 14
Packer, Chipman W ............................... 9             Robinson, Thomas V ............................14             Starley, John R ....................................... 7     Ward, R Charles ....................................11
Packer, McKay B .................................... 5          Robison, Brandon J ..............................15           Starley, Nathan J .................................... 7      Warner, James W ..................................11
Packer, P Berrett .................................... 3        Rockwell, Landon B ..............................14           Steele, Richard H ..... 1, 2, 4, 7, 11, 12, 14                Warr, Edward ....................................... 14
Packer, P Craig ...................................... 3        Rockwell, Michael S ..............................14          Steiner, John E ....................................... 4     Warren, Casey ..................................... 13
Packer, Randell B ................................ 12           Rogers, Robert C ....................................7        Stephenson, James W ........................... 4             Warren, Mark .....................................2, 11
Palmer, Bradley C .................................. 3          Romney, Lawrence C ...........................12              Stevens, David R .................................. 14        Warren, Mark B ...................................... 8
Palmer, Brian S .................................. 3, 7         Romney, Walter A .................................12          Stevens, Wade ..................................... 14        Wasuita, Michael L ............................... 14
Palmer, Kenneth M .............................. 13             Rooklidge, Erik ................................12, 16        Stevenson, Nathan D ........................... 10            Watson, Jeremy R .................................. 1
Palmer, Laurence R ............................... 7            Roring, John L ...................................2, 14       Stewart, Russell .................................... 14      Watson, Michael ....................................11
Palmer, R Clair ..................................... 15        Rosander, Kris H ............................... 6, 11        Stilson, Evan A ....................................... 8     Watts, Robert K .............. 1, 4, 6, 7, 10, 12
Palmer, Robert ..................................... 10         Rosvall, Michael D ..............................1, 4         Stilson, Wilford ........................................ 1   Wayment, David K .................................. 7
Paredes, Cesar ...................................... 5         Roth, David C ..................................13, 15        Stobbe, Aaron ....................................... 14      Wayment, Nathan S ............................... 6
Park, David A ..................................... 8, 9        Roundy, Evan M ................................... 11         Stohl, David R ....................................... 11     Weaver, Jared M ...................................11
Park, Kwang ................................. 1, 7, 12          Rowe, Michael ..................................4, 14         Stohl, John L ......................................... 11    Webb, William H ................................... 15
Parker, Justin O ........................... 5, 6, 12           Rudd, Mitchell G ...................................10        Stohl, Matthew R .................................. 11        Webber, Darren S ................................ 13
Parker, Richard G .................................. 3          Rudelich, Nick J .................................... 11      Stoker, Brigham R ................................ 11         Weber, John P ................................ 6, 8, 9
Parkin, Richard A ..................................11          Rupp, Jeffery .........................................12     Stoker, David S ..................................... 12      Webster, Mark J ................................. 2, 4
Partridge, Judd E ............................. 2, 15           Rupp, Jeffery K ............................. 1, 8, 11        Storheim, John E .................................. 11        Wells, Brett R ....................................... 14
Patton, Bekki T ............................6, 11, 14           Rush, Ryan K ................1, 4, 5, 6, 7, 8, 13             Stosich, Alvin J ....................................... 5    Wells, Mason S ...................................... 4
Payne, Glenn R ...................................... 7         Russell, Kenneth ................................... 11       Stringfellow, Corbin B ........................... 11         Wells, Michael G .................................. 14
Peacock, Steven L ................................. 7           Russell, Michael A ..................................7        Stucki, D. Scott ..................................... 14     West, Daniel ..........................................11
Pearson, G George ...............................11             Russell, Roger T ................................... 11       Stucki, Grant T ........................................ 1    West, E Judd .......................................... 7
Pearson, Jared D ................................... 5          Sachs, Steven .........................................7      Stucki, Randall M .................................... 1      Westmoreland, Tanya P ......................... 5
Peery, Samuel L ..................................... 5         Sampson, Curtis D ................................15          Stucki, Scott C ........................................ 3    White, Jared R ...................................... 15
Perkins, Gregory D ............................... 12           Saunders, Darrell J .................................7        Suekawa, Todd S ................................. 11          White, Jeremy ........................................ 7
Perkins, Robert N ................................. 13          Saunders, Richard D ...............................7          Suisse, Brent ...................................... 5, 7     White, Sage L ......................................... 2
Perrero, Jeffrey E ................................... 9        Saunders, Ryan ......................................7        Sumarauw, Cindy ................................. 11          Whitehouse, Scott M ............................ 14
Perrero, Tyson M ............................. 9, 13            Schiffman, Quinn ....................................9        Sundberg, William ................................ 14         Wible, Darren J ....................................... 4
Perry, Justin T ...................................... 10       Schofield, Natali C ..................................1       Sutton, Phillip J ....................................... 2   Wiest, Gary B ......................................... 9
Petersen, David E ................................ 15           Scholzen, Jeremy .................................14          Swensen, Eric J .................................... 11       Wilcox, Wesley H ................................... 4
Petersen, Douglas A .............................. 6            Schouten, John R .............................9, 13           Swenson, Damon P ................................ 7           Wilding, Alan D ..................................... 14
Petersen, Hans C ................................... 5          Schultz, Bronson ...................................15        Swenson, Michael D ............................... 6          Wilkins, Scott K .................................... 10
Petersen, Luke Russel ......................... 15              Schvaneveldt, Brandon ...........................5            Talbot, Bryon J ....................................... 7     Wilkinson, Stuart D ................................. 5
Petersen, Scott W .................................. 6          Scott, Jay D .......................................9, 13     Talbot, Morrie ....................................... 10     Willden, Ryan H .................................... 13
Peterson, Burke B .................................11           Scott, Kyle S ..................................... 7, 11     Talbot, Travis ........................................ 16    Williams, Chase M .................................. 2
Peterson, Dennis W ..............2, 11, 13, 14                  Scoville, R Kent ...................................2, 8      Talbot, Travis Q .................................. 1, 9      Williams, R Darin .................................. 15
Peterson, John ....................................... 8        Scoville, Ronald J ...................................8       Tavoian, Brian K ..................................... 2      Williams, Zachary T ...............................11
Peterson, John M ............................. 4, 15            Scoville, Ronald James ...........................2           Tayler, Brandon ...................................... 5      Wilson, Gary L ........................................ 9
Petty, Richard O ..................................... 7        Searle, Bryce ..........................................1     Taylor, Colleen P .................................... 2      Winder, George .....1, 2, 4, 7, 8, 11, 12, 14



                                                                                                                                                                                                                             Page 19
                                                            Alphabetical Index

Winegar, Troy H ................................... 12
Wing, Ryan ........................................... 13
Winkel, Kerry M .................................... 15
Wolthuis, Jared .................................7, 11
Wood, Max S .......................................... 9
Woodbury, Spencer ..........................3, 11
Woodbury, William E .............................. 4
Woodward, Brandon ........................ 2, 12
Woodward, Brandon T ......................... 13
Workman, Cameron M ........................... 5
Workman, Ryan ....................................11
Wright, Aaron D .....1, 2, 4, 7, 8, 11, 12, 14
Wright, Aaron David ..............................11
Wright, David N .................................... 13
Wright, James M ...................................11
Wright, Jay W ......................................... 6
Wright, Stephen O ............................ 5, 15
Yates, Robert W ....................................11
Yates, Troy W .......................................11
Yeager, Kevin L ...................................... 9
Young, Christopher ...................... 1, 8, 12
Young, David V .................................. 3, 6
Young, Michael W ........................ 1, 8, 12
Young, Nicolas K .................................... 8
Youngquist, Jeffrey ................................ 8
Zapata, Jorge F ...................................... 7
Zimmermann, Tom C ........................... 15




                                                                                 Page 20
                TM




emihealth.com
-1-
                                                TABLE OF CONTENTS
PLAN SUMMARIES .............................................................................................................................. 2-3


THE DENTAL ECLIPSE II.................................................................................................................... 4-6
     BENEFITS ................................................................................................................................... 5-6
     PROVIDER LISTING .................................................................................... WWW.TDADENTAL.COM


EXECUTIVE PLUS .............................................................................................................................. 7-17
    BENEFITS ................................................................................................................................. 8-17
    PROVIDER LISTING .................................................................................... WWW.TDADENTAL.COM


TDA-COMPANION .......................................................................................................................... 18-20
    BENEFITS ............................................................................................................................... 18-20
    PROVIDER LISTING ................................................................................... WWW.TDADENTAL.COM




                                                                            -1-
                                                                           -9-
                       PLAN SUMMARIES
                 COMPARISON OF DENTAL PLANS


                                  Dental Eclipse II                        Executive Plus
                  Plan Type                 Discount                                 DHMO
                 Coverage
                   Network                In-Network                              In-Network
        Class 1 - Preventive             Approx 75%*                     100% (After $10 Co-pay)*
          Class 2 - Routine              Approx 33%*                             Approx 80%*
             Class 3 - Major             Approx 33%*                             Approx 55%*
            Class 4 - Ortho             25% Discount                            25% Discount
                                     (Children or Adults)                    (Children or Adults)
Maximums and Deductibles
                 Deductible                     None                                  None
          Annual Maximum                   Unlimited                               Unlimited
         Lifetime Maximum                  Unlimited                               Unlimited
          Waiting Periods
                      Basic                     None                                  None
                      Major                     None                                  None
                      Ortho                     None                                  None
         Special Features
                                     No Waiting Periods                      No Waiting Periods
                               No Maximums or Deductibles              No Maximums or Deductibles
                                   Orthodontic Discounts                   Orthodontic Discounts
                                  Large Provider Network                True Specialty Care Benefit
                     Rates
                     Single                     $1.00                                $14.59
                 Two-Party                      $2.00                                $29.18
                     Family                     $2.00                                $48.24
                               *Please refer to fee schedule for co-   *Please refer to fee schedule for co-
                                        payment amounts                         payment amounts




                                         -10-
                                          -1-
                                          -2-
                                       PLAN SUMMARIES
                                 COMPARISON OF DENTAL PLANS


            TDA-Companion
                     Indemnity


       In-Network                Out-Of-Network
         100%                         100%
         100%                         100%
          50%                         50%
          50%                         50%
(Children 50% In/Out Adults 25% Discount In only)          To view a listing of Total Dental
                                                           Administrators, Inc. (TDA)
                                                           Participating Providers, please visit
          $100.00 Per Person (Lifetime)                    our website at www.tdadental.com.
                    $1,200.00
                    $1,000.00
                                                           Not seeing your dentist on the list?
                                                           Refer them to us! Contact TDA at
                       None                                (801) 268-9740 or toll free at (800)
  12 month waiting period (waived for takeover             880-3536 and let us know the
                   benefits)                               dentist you would like us to
                                                           contact.

            See Any Dentist
    or enjoy discounts from nearly 1600 dentists!
        Preventive & Basic covered at 100%
                Lifetime Deductible


                      $36.26
                      $76.23
                      $110.60




                                                     -3-
                                                    -11-
                               THE DENTAL ECLIPSE II

   THE DENTAL ECLIPSE II
The Dental Eclipse II is a discount plan designed to give you significant savings on quality dental care.
This program significantly increases your dental office selection options with over 400 dentists to
choose from.

      Low Monthly rates:                Single              $1.00
                                        Two-Party           $2.00
                                        Family              $2.00




                                Sample Illustration of Savings
                          Dental Eclipse II versus No Dental Insurance

      Procedure (quantity)            Dental Eclipse II     No Dental        Savings       Savings
                                        Copayment           Insurance                        %
    Exam & X-ray (2 per person)            $340.00             $917.00        $577.00         63%
    Cleaning (2 per person)                $310.00             $638.00        $328.00         51%
    Resin 2 Surface Filling (3)            $243.00             $447.00        $204.00         46%
    Crown, Porcelain with Metal (2)        $970.00            $1,598.00       $628.00         39%
    Office Visit Charge (16)                $0.00              $912.00        $912.00        100%
    Premium for 12 Months (Family)          $24.00              $0.00         -$24.00        -100%
              Total                    $1,887.00           $4,512.00      $2,625.00      58%*
      Sample based on typical family of 5
      *Percentage of savings represents this illustration only. Actual savings may vary per
       individual treatment plan.




                                                      -4-
                                                     -12-
                                               THE DENTAL ECLIPSE II
WHAT ARE THE BENEFITS?                                                             Look at the savings with the Dental Eclipse II Plan!
♦ No Deductibles                                                                    Dental                   Usual        Your Plan      Savings in
♦ No Claim Forms                                                                    Service                  Fee          Co-pay         Dollars
♦ No Annual or Lifetime Maximums                                                    Oral Exam                $68.00       $15.00         $53.00
                                                                                    Bitewing X-Rays          $46.00       $25.00         $21.00
♦ Reduced Fees                                                                      Office Visit             $57.00       $ 0.00         $57.00
♦ Orthodontic Coverage (Braces)                                                     Fluoride(to age 14)      $26.00       $ 0.00         $26.00
♦ No Waiting Periods                                                                Cleaning (adult)         $73.00       $35.00         $38.00
♦ Pre-existing Conditions Covered                                                   Savings (74%)            $270         $75            $195
                                                                                   **Usual fee is an average of dental fees throughout the state. The
After your benefits become effective, eligible members                             actual fee and savings may vary
will receive oral exam, x-rays, and cleanings for $75.00.
Additional comprehensive dental services of procedures                                Low Monthly Rates:
are provided at dramatically REDUCED rates see the                                                   Single                   $1.00
schedule of services and co-payments. Members pay                                                    Two-Party                $2.00
ONLY the amount listed for any procedure.                                                            Family                   $2.00

WHAT IS THE DENTAL ECLIPSE II PLAN?
TOTAL DENTAL ADMINISTRATORS, INC. (TDA) has developed “ The Dental Eclipse II”, a discount dental plan to give you significant
savings on quality dental health care. TDA has contracted with established members of the dental profession to deliver quality dental care
services in accordance with the Schedule of Covered Services & Co-payments.

WHERE DO I RECEIVE MY DENTAL CARE?
You choose from the list of participating Dental Eclipse II Plan Providers, the one most convenient for you. All covered family members must
go to the same Dental Eclipse II Plan Provider. The member may change facilities with a 30-day written notice and approval of the Plan.

WHO IS ELIGIBLE?
You and your spouse are eligible, including children up to 26 years of age. Coverage of a child over age 26 will be continued while incapable of
self-sustaining employment by reason of developmental disability or physical handicap.

WHAT OTHER CHARGES WILL I PAY?
You will pay the member co-payments as listed on the Schedule of Covered Services. Any co-payments will be paid directly to your authorized
Plan Dentist at the time of your treatment. You should discuss all future payments and costs before new appointments are made. The Dental
Office staff will help you plan your dental treatment and payments. You will receive a 20% discount for all procedures not listed in the Schedule
of Covered Services. Procedures performed by Endodontists, Periodontists, Pedodontists, and Oral Surgeon is provided at a 20% discount.

IS SPECIALTY CARE COVERED?
YES, fees for Participating Plan Specialist (Endodontists, Periodontists, and Oral Surgeons) where available, will be discounted by 20%.

WHAT IF I HAVE OTHER DENTAL COVERAGE?
Dental Eclipse II is not dental insurance or a pre-paid dental plan and is not designed to coordinate with any other dental programs. If you have
dental insurance or a pre-paid dental plan, all fees will be based on the maximum plan reimbursement normally charged or the pre-paid plan's
schedule of co-payments
LIMITATIONS & EXCLUSIONS                                                 ORTHO PLAN EXCLUSIONS & LIMIITATIONS
    Dental care, which in the opinion of the attending dentist, is not      No benefits will apply for a treatment program which began before the
    necessary to the patient’s dental health.                               Subscriber enrolled in the Orthodontic Plan.
    Oral surgery requiring the setting of fractures or dislocations.        No benefits will apply for lost or broken appliances.
    Treatment for Myofunctinal therapy, except as provided herein.          Extractions are not included as a benefit.
    Dispensing of drugs and medications not normally supplies in a          Additional fees may be charged by the dentist for:
    dental office.                                                          Care required in excess of 24 months from the time of banding, Gross non-
    Treatment of malignancies, cysts, neoplasms or congenital               cooperation, Accidents occurring during the period of treatment, Cases
    malformations.                                                          involving surgical orthodontics, Cases involving myofunctional therapy or
    The cost of hospital care for any dental procedures(s).                 T.M.J
    Loss or theft of dentures or bridgework.                                If the Subscriber relocates to an area and is unable to receive treatment from
    Services that cannot be performed because of the general health         a member orthodontist, coverage under this program ceases and it becomes
    of the Member.                                                          the obligation of the Subscriber to pay the usual and customary fee of the
    Services provided by a non-plan provider.                               Orthodontist where the treatment is completed.
    Services covered by Worker’s Compensation, employer liability           Choice of Orthodontist, initially, after treatment begins or upon change or
    laws, no cost services provided by any municipality, county or          residence is limited to Orthodontists participating in this program or who
    other governmental agency or when coverage is provided by any           would accept the fees outlined.
    other group plan (insurance or prepaid).                                If the Subscriber becomes ineligible during the course of treatment,
                                                                            coverage under this program ceases and it becomes the obligation of the
                                                                            Subscriber to pay the entire remaining balance.

                                                                             -5-
                                                                            -13-
                                              THE DENTAL ECLIPSE II
                                                 SCHEDULE OF BENEFITS AND CO-PAYMENTS

  Code                          Description                  Fee             Code                                Description                            Fee
                                Diagnostic                                 D3320        Root Canal Therapy - bicuspid                                   $378
D0120      Exam, periodic                                    $15           D3330        Root Canal Therapy - molar                                      $500
D0140      Exam, problem focused                             $15           D3410        Apicoectomy-anterior                                            $326
D0150      Exam, comp, new or established patient            $15           D3421        Apicoectomy-bicuspid - 1st root                                 $356
D0180      Exam, periodontal, including charting             $15           D3425        Apicoectomy-molar - 1st root                                    $402
D9440      Exam, problem focused, after regular hours        $47           D3426        Apicoectomy-each additional root                                $134
D9999      Missed/cancelled appt w/o 24 hour notice          $25           D3430        Retrograde filling, per root                                     $99
                                     Preventative                                       Periodontics when performed by General Dentist
D0210      Full mouth x-ray, intraoral                        $58          D4210        Gingivectomy/Gingivoplasty 4+ teeth per quad                    $226
D0220      Single x-ray, intraoral, periapical                $11          D4211        Gingivectomy/Gingivoplasty 1 to 3 teeth per quad                 $70
D0230      Single x-ray, intraoral, periapical, additional     $9                       Osseous Surgery, including flap entry and closure 4 or
D0270      Bitewing x-ray 1 film                              $12          D4260        more teeth - quad                                               $450
D0272      Bitewing x-ray 2 films                             $15                       Osseous Surgery, including flap entry and closure 1 to 3
D0274      Bitewing x-ray 4 films                             $25          D4261        teeth - quad                                                    $275
D0330      Panoramic x-ray                                    $50          D4341        Scaling/root planing, 4+ teeth per quad                         $106
D0460      Pulp vitality test - 1 or more teeth               $18          D4342        Scaling/root planing, 1 to 3 teeth per quad                      $95
D0470      Diagnostic Models                                  $39          D4355        Full mouth debridement to enable evaluation and diagnosis        $71
D1110      Prophylaxis (cleaning) adult                       $35          D4910        Periodontal maintenance, per visit                               $64
D1120      Prophylaxis (cleaning) child                       $25                       Removable Prosthodontics-Dentures/Partials
D1203-04   Fluoride treatment, topical                        $15          D5110-20     Complete denture-per arch                                       $693
D1320      Tobacco Counsel - Control/Prev Disease             $18          D5130-40     Complete Immed denture-per arch                                 $765
D1351      Sealant - per tooth                                $21                       Partial dent-cast frame resin base conv clasps, rests, teeth,
D1510      Space maintainer-fixed unilateral                 $131          D5213-14     per arch                                                        $710
D1515      Space maintainer-fixed bilateral                  $174                       Removable unilateral partial denture cast metal, all clasps
                                                                           D5281        and teeth                                                       $373
D1550      Recement Space Maintainer                          $28
                                                                           D5510        Partial dent-repair base, per arch                               $63
                                Restorative (Fillings)
                                                                           D5520        Dent/partial replace teeth, each tooth                           $68
D2140      Amalgam-1 surface, prim or perm                    $50
                                                                           D5620        Partial denture-repair cast framework                            $74
D2150      Amalgam-2 surface, prim or perm                    $62
                                                                           D5630-5660   Partial dent repair/replace/add clasp                            $85
D2160      Amalgam-3 surface, prim or perm                    $79
                                                                           D5730-5731   Reline complete denture,chairside/per/arch                      $132
D2161      Amalgam-4 surface or more, prim or perm            $97
                                                                           D5740-5741   Reline partial denture, chairside, per arch                     $121
D2330      Resin-1 surface-anterior                           $62
                                                                           D5750-5751   Reline complete denture in lab, per arch                        $180
D2331      Resin-2 surface-anterior                           $81
                                                                           D5760-5761   Reline partial denture in lab, per arch                         $174
D2332      Resin-3 surface-anterior                           $97
                                                                           D5820-5821   Interim partial denture, per arch                               $230
D2335      Resin-4 or more surface-anterior                  $116
                                                                                        Fixed Prosthodontics (Bridges)
D2391      Resin-1 surface-posterior                          $68
                                                                           D6210        Pontic-Cast-high noble metal                                    $475
D2392      Resin-2 surface-posterior                          $91
                                                                           D6211        Pontic-Cast base metal                                          $432
D2393      Resin-3 surface-posterior                         $112
                                                                           D6212        Pontic-Cast nobel metal                                         $450
D2394      Resin-4 or more surface-posterior                 $119
                                                                           D6240        Pontic-Porcelain/high noble metal                               $500
                             Inlay/Onlay Restorations
                                                                           D6241        Pontic-Porcelain-predom base metal                              $475
D2510      Inlay-metallic 1-surface                          $335
                                                                           D6242        Pontic-Porcelain/noble metal                                    $480
D2520      Inlay-metallic 2-surface                          $380
                                                                           D6245        Pontic-Porcelain/ceramic                                        $440
D2530      Inlay-metallic 3-or more surfaces                 $438
                                                                           D6740        Crown-Porcelain ceramic                                         $508
D2542      Onlay-metallic 2 surfaces                         $380
                                                                           D6750        Crown-Porcelain/high nobel metal                                $520
D2543      Onlay-metallic 3 surface                          $449
                                                                           D6751        Crown-Porcelain/base metal                                      $485
D2544      Onlay-metallic 4 or more surfaces                 $467
                                                                           D6752        Crown-Porcelain noble metal                                     $497
D2610      Inlay-ceramic 1 surface                           $394
                                                                           D6790        Crown-cast high noble metal                                     $502
D2620      Inlay-ceramic 2 surface                           $416
                                                                           D6791        Crown-cast base metal                                           $476
                             Inlay/Onlay Restorations
                                                                           D6792        Crown-cast noble metal                                          $493
D2630      Inlay-ceramic 3 or more surfaces                  $443
                                                                           D6930        Recementation of bridge                                          $61
D2642      Onlay-ceramic 2 surface                           $430
                                                                           D6970        Cast post/core per tooth                                        $168
D2643      Onlay-ceramic 3 surface                           $464
                                                                           D6973        Core buildup- including pins                                    $110
D2644      Onlay-ceramic 4 or more surfaces                  $492
                                                                                             Oral Surgery performed by General Dentist.
D2740      Crown-Porcelain/ceramic substrate                 $550
                                                                           D7111        Extraction-coronal remnants, prim                                $53
D2750      Crown-Porcelain high noble metal                  $530
                                                                           D7140        Extraction-erupted tooth                                         $60
D2751      Crown-Porcelain fused to base metal               $485
                                                                           D7210        Extraction-erupted tooth surgical                               $100
D2752      Crown-Porcelain fused to noble metal              $495
                                                                           D7220        Extraction-soft tissue impaction                                $130
D2790      Crown-full cast high noble metal                  $481
                                                                           D7230        Extraction-partial bony impaction                               $164
D2791      Crown-full cast-base metal                        $455
                                                                           D7240        Extraction-comp bony impaction                                  $195
D2792      Crown-full cast-noble metal                       $464
                                                                                                             Cosmetic Dentistry
D2920      Recementation of crown                             $38
                                                                           D2960        Labial Veneer (resin laminated) chairside                       $307
D2930      Crown-prefab stainless steel, prim tooth          $104
                                                                           D2961        Labial Veneer (resin laminated) laboratory                      $344
D2950      Core build up/including pins, per tooth            $99
                                                                           D2962        Labial Veneer (porcelain laminate)                              $374
D2951      Pin retention, in addition to restoration          $21
                                                                           D9940        Occlusal guard, by report                                       $200
D2952      Cast post/core in addition to crown               $175
                                                                           D9941        Fabrication of athletic mouthguard                               $58
D2954      Prefab/post/core in addition to crown             $125
                                                                           D9972        Bleaching - take home trays                                     20% Off
           Endodontics when performed by General Dentist
                                                                           D9999        Bleaching - in office bleaching                                 20% Off
D3220      Therapeutic pulpotomy                              $67
D3221      Pulp debridement/not done as part of RCT           $49                                               Orthodontics                            25%
D3310      Root Canal Therapy - anterior                     $317          D8000-8999   Diagnostic Workup, x-rays/models                                Off


                                                                     -6-
                                                                    -14-
                                      EXECUTIVE PLUS



   Executive Plus
The Executive Plus provides you and your family with quality care at reasonable and predictable prices.
Services are provided by a panel of quality dentists. Special features include: no deductibles, pre-
existing conditions are covered, no annual or lifetime maximums, preventative care covered in full once
every 6 months and specialty care is a covered benefit.

      Low monthly premiums:             Single    $14.59
                                        Two Party $29.18
                                        Family    $48.24




                               Sample Illustration of Savings
                           Executive Plus versus No Dental Insurance

      Procedure (quantity)            Executive Plus       No Dental      Savings       Savings
                                       Copayment           Insurance                      %
    Exam & X-ray (2 per person)            $0.00            $963.00         $963.00       100%
    Cleaning (2 per person)                $0.00            $670.00         $670.00       100%
    Resin 2 Surface Filling (3)           $150.00           $520.00         $370.00        71%
    Crown, Porcelain with Metal (2)       $850.00           $1750.00        $900.00        51%
    Office Visit Charge (16)              $160.00           $956.00         $796.00        80%
    Premium for 12 Months (Family)        $578.88            $0.00         -$578.88       -100%
              Total                   $1,738.88           $4,859.00       $3,120.12         *
      Sample based on typical family of 5
      *Percentage of savings represents this illustration only. Actual savings may vary per
       individual treatment plan.




                                                    -9-
                                                     -7-
       TOTAL CARE
A Division of Total Dental Administrators of Utah, Inc. (TDAUT, Inc.) domiciled in Utah




                GROUP DENTAL PLAN
                   Executive Plus
         A Comprehensive DHMO Program with Specialty Care Coverage


            Retain this for your Enrollment and Employee Plan Booklet
                            Welcome to Total Care
Total Care is a comprehensive "Managed Care" Group Dental Program marketed, managed and
administered by Total Dental Administrators of Utah, Inc. (TDAUT) domiciled in Utah and its parent
company Total Dental Administrators, Inc. TDAUT "Your Total Dental Insurance Benefit Special-
ist", has contracted with established private practicing dentists to provide you convenient, affordable
and quality dental care.



    TOTAL CARE DENTAL COVERAGE                              TOTAL CARE ADVANTAGES
    Dental coverage includes dental                        • No deductibles
    services and treatment for:                            • No claim forms
    • Diagnostic                                           • No annual or lifetime benefit maximums
    • Preventive                Refer to the               • No industry exclusions
    • Restorative                enclosed                  • Covers Pre-existing conditions
    • Endodontics               Schedule of                • Covers Orthodontics (Braces)
    • Periodontics             Benefits and                • Local service
                               Co-payments
    • Prosthodontics
                               for a detailed
    • Oral surgery            listing of cov-
    • TMJ                       ered proce-
    • Orthodontics                 dures.
    • Cosmetic



Low Monthly Rates
We have enclosed a premium rate form that applies to your specific group.
Please contact your Employer or our Administrative Office should you have any questions.

How To Enroll
1. Complete the enclosed enrollment card. Include information about your spouse and/or child(ren)
   if you are applying for dependent coverage.
2. Select the general dental office you and your dependents wish to use from the enclosed Participating
   Provider Directory. Each participating dental facility listed in the Provider Directory has a Dental Office
   Code number listed to the left of the dental office. Be sure to use the CODE number to identify your
   selection on the Enrollment Form.
3. Premium payment is made by payroll deduction, if employee contributions are required. Turn your
   enrollment card into your Employer's personnel office or benefits department for processing.



   FOR MORE INFORMATION CALL:
   (801) 268-9740 or toll free 1-800-880-3536
   Total Dental Administrators of Utah Inc. (TDAUT)
   969 East Murray Holladay Road, Suite 4E Salt Lake City, Utah 84117
   www.tdadental.com




                                                          FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+              2
  SAMPLE COST COMPARISON
   ADA                                                                 Usual and                  Plan                Savings          Percent
   Code             Procedure                                        Customary Fee*             Copayment            in Dollars        Savings

  Preventive
  D0210          Complete series x-rays                                     $127.00                $0.00             $127.00            100%
  D0150          Initial Oral Exam                                           $72.00                $0.00              $72.00            100%
  D1110          Adult - Prophylaxis (Cleaning)                              $76.00                $0.00              $76.00            100%
  D9430          O ce Visit                                                  $68.00               $10.00              $58.00             85%
  Restorative
  D2140       Amalgam - One Surface                                         $133.00               $25.00             $108.00             81%
  D2330       Resin - One Surface                                           $120.00               $42.00              $78.00             65%
  Crown & Bridge
  D2750      Crown porcelain Hi Noble Metal                                 $907.00              $400.00**           $507.00             56%
  D2950      Crown buildup, including any pins                              $222.00               $75.00             $147.00             66%
  Endodontics
  D3310      RCT-1 Canal                                                    $616.00               $195.00            $421.00             68%
  D3330      RCT-3 Canals                                                   $972.00               $365.00            $607.00             62%
  Oral Surgery
  D7140       Extraction, erupted tooth exposed roots                       $129.00               $40.00              $89.00             69%
  D7220       Soft Tissue Impaction                                         $293.00               $80.00             $213.00             73%
  Prosthetics
  D5110/20         Complete Upper/Lower Denture                          $1,486.00              $675.00***           $811.00             55%
  Periodontics
  D4260        Osseous surgery/quad                                      $1,256.00                $380.00            $876.00             70%
  Orthodontics
  D8080       24 Month Orthodontic Treatment                             $4,700.00            25% Discount          $1,175.00            25%
 *Usual fee is an average of dental fees throughout the state. The actual fee and savings may vary. **D2750 copayment is $275 + Lab Fee – approxi-
 mate lab fee of $125. Lab fees may vary. ***D5211-12 copayment is $275 + Lab Fee – approximate lab fee of $400. Lab fees may vary.

 Dental Plan Information
 This Employee Plan Booklet explains the Benefits, Limitations, Exclusions, provisions and conditions of your
 Coverage through the Group Agreement your organization has with TDAUT, Inc. The Group Agreement is the
 document which specifies any rights to Benefits you may have. If the explanations in this Employee Plan Booklet
 can be interpreted differently from the provisions of the Group Agreement, the Group Agreement shall always
 control. You may examine the Group Agreement by contacting your organization or by contacting TDAUT, Inc.
 at: 969 East Murray Holladay Road Suite 4E, Salt Lake City, Utah 84117
 Telephone: (801) 268-9740 or Toll Free 1-800-880-3536

 Please read this document with care so that you will have a full understanding of the Plan and what it could mean
 to you and your family. This document is void and of no effect if you are not entitled to or have ceased to be entitled
 to the dental coverage.


 I Eligibility
 A. You are eligible if you are a full-time employee, working within an eligible class.
 B. Eligible dependents include your spouse and your child(ren), who are dependent on you for their
    support, through the last day of the month in which they turn age 26; Newborn and adopted children are
    covered from the moment of birth or date of placement; Children for whom a court order of support applies.
 C. The date of eligibility is determined by your Organization. Newborn children are covered the first day of the
    month following the date of birth and legally adopted children, foster children, and stepchildren are covered
    the first day of the month following placement, as long as TDAUT is notified within thirty (30) days and any
    Prepayment fee is paid within that period. Check with your Employer Organization if you have any questions
    about when coverage begins.
 D. Dependents of an Enrollee who are in active military service are not eligible for coverage under the Plan.

 The eligibility of all Covered Persons, for the purpose of receiving benefits under the Plan, shall, at all times, be
 contingent upon the applicable monthly premium payment having been made for such Covered Persons by the
 Group on a current basis.

FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+                               3
                                                                       EXECUTIVE PLUS
                                             II. Schedule of Bene ts and Copayments
ADA                                                                                  ADA
Code       Procedure Description                                       Co-payment    Code       Procedure Description                                  Co-payment
Diagnostic                                                                           Restorative (Continued)
D0120      Periodic oral exam (twice in any 12 consecutive month)             N/C    D2940      Sedative filling                                                   $22
D0120      Periodic oral exam (additional)                                    $15    D2950      Crown buildup, including any pins                                  $75
D0140      Emergency oral exam (during office hours)                          $25    D2951      Pin retention per tooth                                            $10
D0145      Oral exam for patient under 3 years of age                         N/C    D2952      Cast post and core                                                 $85
D0150      Initial oral exam (twice in any 12 consecutive months)             N/C    D2954      Prefabricated post and core                                        $75
D0150      Initial oral exam (additional)                                     $20    D2960      Labial veneer laminate - chairside                                $250
D0170      Re-Evaluation - limited, problem focused                           $25    D2970      Temporary crown (Fractured Tooth)                                  N/C
D0180      Comprehensive periodontal evaluation                                      D2980      Repair crown                                                       N/C
             (twice in any 12 consecutive months)                             N/C
D0210      Intraoral - complete including bitewing x-ray                             Endodontics**
             (once in a 3 year period)                                        N/C    (Treatment from a Plan specialist MUST be pre-approved by the Plan, TDAUT,
D0220      Single periapical x-ray                                            N/C    PRIOR to any services rendered.)
D0230      Periapical x-ray - each additional x-ray                           N/C    D3110      Pulp capping/direct                                          $20
D0270/72   Bitewing x-rays - single & two films(once in a 6 mo period)        N/C    D3120      Pulp capping/indirect                                        $17
D0272      Bitewing x-rays - two films (additional)                           $12    D3220      Therapeutic pulpotomy                                        $43
D0273      Bitewing x-rays - three films (once in a 6 mo period)              N/C    D3230      Pulpal Therapy (Resorbable Filling) Anterior Primary         $45
D0274      Bitewing x-rays - four films (once in a 6 mo period)               N/C    D3240      Pulpal Therapy (Resorbable Filling) Posterior Primary        $45
D0274      Bitewing x-rays - four films (additional)                          $25    D3310      Root Canal Therapy - anterior                              $195
D0277      Verticle Bitewing x-rays (once in a 6 mo period)                   N/C    D3320      Root Canal Therapy - bicuspid                              $270
D0330      Panoramic film-incl. bitewing x-rays(once in a 3 year period)      N/C    D3330      Root Canal Therapy - molar                                 $365
D0470      Diagnostic casts                                                   N/C    D3346      Retreat Previous RCT anterior                       20% Discount
D9310      Consultation                                                       N/C    D3347      Retreat Previous RCT bicuspid                       20% Discount
D9430      Office Visit                                                       $10    D3348      Retreat Previous RCT molar                          20% Discount
D9999      Sterilization                                                      N/C    D3351      Apexification/Recalcification-Initial               20% Discount
                                                                                     D3352      Apexification/Recalcification-Interiml              20% Discount
Preventive                                                                           D3353      Apexification/Recalcification-Final                 20% Discount
D1110      Prophylaxis-Adult (once in a 6 month period)                    N/C       D3410      Apicoectomy per tooth (anterior only)                      $250
D1110      Prophylaxis-Adult (additional)                                   $37      D3421      Apicoectomy per tooth (bicuspid)                    20% Discount
D1120      Prophylaxis-Child (once in a 6 month period)                    N/C       D3425      Apicoectomy per tooth (molar)                       20% Discount
D1120      Prophylaxis-Child (additional)                                   $25      D3426      Apicoectomy per tooth (each add)                    20% Discount
D1203      Fluoride treatment (once in a 12 month period to age 15)        N/C       D3430      Retro fill per tooth                                         $85
D1310      Dietary planning                                                N/C       D3450      Root amputation                                              $95
D1330      Preventive dental education, home care                          N/C       D3920      Hemisection                                                $125
D1351      Sealant per tooth                                                $12
D1510      Space maintainer -fixed unilateral                       $30+Lab Fee      Periodontics**
D1515      Space Maintainer -fixed bilateral                        $50+Lab Fee      (Treatment from a Plan specialist MUST be pre-approved by the Plan, TDAUT,
D1520      Space Maintainer -removable unilateral                   $30+Lab Fee      PRIOR to any services rendered.)
D1525      Space Maintainer -removable bilateral                    $50+Lab Fee      D4210      Gingivectomy or gingivoplasty/quad                        $200
D1550      Recement space maintainer                                        $15      D4211      Gingivectomy or gingivoplasty/tooth                         $60
                                                                                     D4240      Gingival flap procedure inc. rt. Planning 4+ teeth        $250
Restorative                                                                          D4241      Gingival flap procedure inc. rt. Planning 1-3 teeth       $150
D2140      Amalgam - 1 surface permanent                                       $25   D4260      Osseous surg/quad (flap entry & closure) 4+ teeth         $380
D2150      Amalgam - 2 surface permanent                                       $34   D4261      Osseous surg/tooth (flap entry & closure) 1-3 teeth       $250
D2160      Amalgam - 3 surface permanent                                       $45   D4320      Provisional splinting - intracoronal                      $100
D2161      Amalgam - 4 or more surfaces permanent                              $60   D4321      Provisional splinting - extracoronal                      $100
D2330      Resin - 1 surface anterior                                          $42   D4341      Periodontal scaling & root planing/quad 4+ teeth            $90
D2331      Resin - 2 surfaces anterior                                         $50   D4342      Periodontal scaling & root planing/tooth 1-3 teeth          $60
D2332      Resin - 3 surfaces anterior                                         $60   D4355      Full mouth debridement                                      $55
D2335      Resin - 4 or more surfaces anterior                                 $70   D4381      Local Delivery–Chemo to Tissue                     20% Discount
D2390      Resin – based composite crown, anterior                             $90   D4910      Periodontal maintenance following active therapy            $55
D2391      Resin - 1 surface posterior                                         $49
D2392      Resin - 2 surface posterior                                         $74   Removable Prosthodontics
D2393      Resin - 3 surface posterior                                         $89   D5110    Complete upper denture(3 adj. w/in 60 days)                $275+Lab Fee
D2394      Resin - 4 or more surfaces posterior                              $105    D5120    Complete lower denture(3 adj. w/in 60 days)                $275+Lab Fee
D2510      Inlay metallic - 1 surface                                        $145    D5130    Immediate upper denture(4 adj. w/in 60 days)               $275+Lab Fee
D2520      Inlay metallic - 2 surfaces                                       $180    D5140    Immediate lower denture(4 adj. w/in 60 days)               $275+Lab Fee
D2530      Inlay metallic - 3 surfaces                                       $225    D5211/12 Upper or lower partial - resin base                        $275+Lab Fee
D2542      Onlay metallic - 2 surfaces                                       $180    D5213/14 Upper or lower partial - cast metal base w/resin
D2543      Onlay metallic - 3 surfaces                                       $220             saddles (including any conventional clasps, rests & teeth) $275+Lab Fee
D2544      Onlay metallic - 4 or more surfaces                               $250    D5281    Removable unilateral partial denture                              $250
D2710      Acrylic (plastic) crown - lab processed                           $110    D5410-22 Denture adjustment (upper, lower, complete or partial)              $35
D2720-22   Acrylic w/metal crown                                      $275+Lab Fee   D5510    Repair broken complete denture base                         $20+Lab Fee
D2740      Porcelain crown                                            $275+Lab Fee   D5520    Replace missing/broken teeth complete denture base $20+Lab Fee
D2750-52   Porcelain w/metal crown                                    $275+Lab Fee   D5610    Repair resin saddle or base                                 $25+Lab Fee
D2780-82   3/4 metal crown                                            $200+Lab Fee   D5620    Repair cast framework                                       $25+Lab Fee
D2783      3/4 ceramic crown                                          $200+Lab Fee   D5630    Repair or replace broken clasp                              $30+Lab Fee
D2790-92   Full crown                                                 $275+Lab Fee   D5640    Replace broken teeth (per tooth)                            $20+Lab Fee
D2910-20   Recement crown, inlay, facing only                                  $20   D5650    Add tooth to existing partial denture                       $20+Lab Fee
D2930      Stainless steel crown primary tooth                                 $55   D5660    Add clasp to existing partial denture                       $20+Lab Fee
D2932      Prefabricated resin crown                                           $75   D5670/71 Replace all teeth and acrylic-cast metal                   20% Discount
D2933/34   Prefabricated stainless steel crown                               $100    D5710-21 Rebase (upper, lower, complete or partial)                  $25+Lab Fee



                                                                                     FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+                                      4
                                                                 EXECUTIVE PLUS
                                   II. Schedule of Bene ts and Copayments Continued
ADA                                                                                     ADA
Code       Procedure Description                                  Co-payment            Code       Procedure Description                                  Co-payment
Removable Prosthodontics (Continued)                                                    Orthodontics (Continued)
D5730-41 Reline chairside (Upper, lower, complete or partial)             $70           D8693      Rebonding/recementing; and/or repair, as
D5750-61 Reline lab (Upper, lower, complete or partial)           $45+Lab Fee                      Required, of fixed retainers                        15-25% Discount
D5850    Tissue reconditioning per denture                                $30           D8999      Unspecified orthodontic procedure                   15-25% Discount

Fixed Prosthodonitcs                                                                    Temporomandibular Joint Dysfunction (TMJ)
D6010-95   Implant procedures                                   20% Discount                       TMJ Treatment                                       15-25% Discount
D6100-99   Implant procedures continued                         20% Discount
D6210-12   Cast pontic                                          $275+Lab Fee            Other Services
D6240-42   Porcelain w/metal pontic                             $275+Lab Fee            D9110      Emergency palliative treatment                                $35
D6245      Porcelain ceramic pontic                             $275+Lab Fee            D9210      Local anesthetic                                              N/C
D6250-52   Acrylic pontic                                       $275+Lab Fee            D9230      Analgesia / Nitrous oxide                                     $20
D6545      Cast metal retainer for acid etch bridge (Maryland                           D9310      Consultation                                                  N/C
           Bridge - per unit)                                          $175             D9430      Office Visit (during regular scheduled hours)                 $10
D6720-22   Acrylic w/metal crown retainer                       $275+Lab Fee            D9440      Office visit (after regular scheduled hours)                  $35
D6740      Porcelain ceramic crown retainer                     $275+Lab Fee            D9940      Nightguard-occlusal guard (limited to one in a 12
D6750-52   Porcelain w/metal crown retainer                     $275+Lab Fee                       month period)                                                 $155
D6780-83   3/4 metal crown retainer                             $200+Lab Fee            D9951      Occlusal adjustment - limited per visit                        $25
D6790-92   Full metal crown retainer                            $275+Lab Fee            D9952      Occlusal adjustment - complete                                 $90
D6920      Connector Bar                                                 $45            D9972      Cosmetic Bleaching, Per arch                                  $110
D6930      Recement bridge - per cemented unit                           $30            D9973      Cosmetic Bleaching, per tooth                                  $10
D6940      Stress breaker, simple                                $25+Lab Fee            D9999      Missed/canceled appointment (without 24 hour notice)           $25
D6950      Precision attachment                                        $150
D6980      Bridge repair                                         $25+Lab Fee
                                                                                        SPECIAL LIMITATIONS
Oral Surgery**                                                                          • This Schedule Of Benefits And Co-payments is for non-precious metals
(Treatment from a Plan specialist MUST be pre-approved by the Plan, TDAUT,                only. If gold is used, there will be an additional charge according to the
PRIOR to any services rendered.)
                                                                                          current market value of gold.
D7111      Extraction, coronal remnants – decidusous tooth           $30                • Procedures or services not listed will be provided at Usual &
D7140      Extraction, erupted tooth or exposed roots                $40                  Customary fees.
D7210      Surgical extraction                                       $80
D7220      Soft tissue impaction                                     $80                *Orthodontic coverage is the discount filed with TDAUT. Please see
D7230      Partial bony impaction                                    $95                 provider listing for details.
D7240      Complete bony impaction                                 $115
D7241      Complete bony impaction with complications              $125                 ** ENDODONTIC, PERIODONTIC AND ORAL SURGERY
D7250      Surgical root recovery                                    $60                   TREATMENTS FROM A PLAN SPECIALIST MUST BE
D7270      Tooth reimplantation & stabilization                    $125                    PRE-APPROVED BY THE PLAN ADMINISTRATOR, TDAUT,
D7280      Surgical exposure of impacted tooth                     $160                    PRIOR TO ANY SERVICES RENDERED.
D7286      Biopsy of oral tissue - soft                      $35+Lab Fee
D7310      Alveoloplasty/quad with extraction 1 to 3 teeth           $80                   SPECIALITY CARE SERVICES NOT LISTED ARE DISCOUNTED
D7311      Alveoloplasty/quad with extraction 4 or more teeth        $40                   BY THE RATE FILED WITH TDAUT INC
D7320      Aveoloplasty/quad w/out extraction 1 to 3 teeth         $200
D7321      Aveoloplasty/quad w/out extraction 4 or more teeth        $85                *** Pedodontic coverage is the discount filed with TDAUT
D7471      Removal of exostosis - maxilla or mandible              $265                     (20-25% off the participating pedodontists regular fee).
D7510      Intra - oral I & D or abscess                             $65
D7911      Simple suture (includes post op. visit)                    $0
D7960      Frenectomy                                              $140

Orthodontics
D8010      Limited orthodontic treatment-primary dentition      15-25% Discount
D8020      Limited orthodontic treatment-transitional dentition 15-25% Discount
D8030      Limited orthodontic treatment-adolescent dentition 15-25% Discount
D8040      Limited orthodontic treatment-adult dentition        15-25% Discount
D8050      Interceptive orthodontic treatment-primary
           dentition                                            15-25% Discount
D8060      Interceptive orthodontic treatment-transitional
           dentition                                            15-25% Discount
D8070      Comprehensive orthodontic treatment-transitional
           dentition                                            15-25% Discount
D8080      Comprehensive orthodontic treatment-adolescent
           dentition                                            15-25% Discount
D8090      Comprehensive orthodontic treatment-adult
           dentition                                            15-25% Discount
D8210      Removable appliance therapy                          15-25% Discount
D8220      Fixed appliance therapy                              15-25% Discount
D8660      Pre-orthodontic treatment visit                      15-25% Discount
D8670      Periodic orthodontic TX visit                        15-25% Discount
D8680      Orthodontic retention-removal of appliance, construct
           and place retainer(s)                                15-25%   Discount
D8690      Orthodontic TX (alter bill to contract)              15-25%   Discount
D8691      Repair of orthodontic appliance                      15-25%   Discount
D8692      Replacement of lost or broken retainer               15-25%   Discount




  FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+                                         5
III. Co-payments - The Co-payment amount in the Schedule Of Benefits and Co-Payments, contained herein are
payable by you directly to the Dental Office as treatment is received. You should discuss all future payments and costs
before new appointments are made. The Dental Office staff will help you plan your dental treatment and payments.

IV. Specialty Care - Sometimes your selected dentist will identify a problem that is best treated by a specialist.
In this case, your dentist will refer you, where available, to a fully qualified specialist in the Total Care Dental Network
who specializes in the care you need. Depending on your plan of coverage (refer to your Schedule of Benefits and
Co-Payments), treatment provided by a specialist may require Plan authorization. Your selected Plan Provider will
initiate this authorization. Eligible dental care services from a specialist are those services specifically listed under the
specialist category of the Schedule of Benefits and Co-payments.

V. Extended Care - Upon termination of eligibility or termination of the Group Agreement, the Plan will complete
any procedures started, but only the procedures in progress.

VI. Effective Date of Coverage
    A. Initial enrollment must be made within thirty (30) days following the date of hire or the Employer's period
       of probation. If enrollment is received prior to the fifteenth (15th) day of the month, coverage will begin on
       the first day of the following month. If TDAUT does not receive the completed application as required above,
       the Employee must wait until the next open enrollment period.
    B. A spouse and child(ren), newly acquired through marriage, must make application within thirty (30) days
       of marriage. If said application is received prior to the fifteenth (15th) day of the month, coverage will begin
       on the first day of the following month. Except for newborn natural children and adopted children, who are
       enrolled within sixty (60) days from the date of the birth of the natural child or sixty (60) days after
       placement of the adopted child, family members, who do not enroll during the initial enrollment period, cannot
       enroll until the next annual open enrollment period.

VII. Participating Plan Providers (Dentists)
   A. Benefits Obtained From Plan Providers - Except for out-of area emergency care, benefits are available only from
      your selected Plan Provider.
   B. List of Plan Providers - You may obtain a current list of Plan Providers from the Plan's Administrative Office
      located at 969 East Murray Holladay Road, Suite 4E,Salt Lake City, Utah 84117, telephone no. (801) 268-9740
      or 1-800-880-3536.
   C. Choosing a Plan Provider -You may choose any Plan Provider from the list of Plan Providers referred to above.
      Upon request, the Plan Administrator will assist you in selecting a Plan Dentist; but may not recommend any
      particular dentist. All covered family members must go to the same Plan Provider. You must choose a Plan
      Provider at the time you enroll. You must have a Plan provider to receive benefits.
   D. Changing Plan Providers - You may change Plan Providers. If you notify the Plan, in writing, by the fifteenth
      (15th) day of the month, the change will be effective on the first of the following month. Should your Plan
      Provider stop participation, the Plan reserves the right to transfer you to another Plan Provider of your choosing.

   All Plan Providers (Dentists) furnishing services to a Member do so as independent contractors. TDAUT shall
   not be liable for any claim or demand for damages arising out of or in any manner connected with any injuries
   suffered by a Member while receiving dental services.

VIII. Emergency Care
   A. If you are less than fifty (50) miles from your Plan Provider, you should always attempt to obtain emergency
      care from your Plan Provider FIRST.
   B. If you are seeking emergency care during normal business hours and your selected Plan Provider is not
      accessible, you should contact the Plan for assistance at (801) 268-9740 or 1-800-880-3536.
   C. If your Plan Provider is not accessible and after you have made a reasonable attempt to contact the Plan for
      assistance or you are more than fifty (50) miles from your Plan Provider, then you should seek emergency
      dental care for the relief of pain, bleeding or swelling from any licensed dentist. Under such circumstances, the
      Plan will pay up to a maximum of $50.00 per contract year per person. A written itemized statement for these
      services must be presented to TDAUT, Inc. for reimbursement. If it is necessary to have additional treatment, it
      must be done by your Plan Provider.
IX. Scheduling An Appointment - After your Plan becomes effective, you can schedule an appointment by
contacting your selected participating Provider. Your dentist will offer you an appointment generally within thirty
(30) days of your call - or within 24 hours for emergency care. Most dental appointments are scheduled Monday



                                                               FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+                        6
through Friday during regular working hours. Each Plan Provider is an independent practitioner who establishes his
or her own hours. Some have evening and/or weekend hours. Call your Plan Provider to ask about office hours and
the availability of emergency dental services.

X. Plan Identification Card - Although an I.D. card will be issued to you, it is not necessary in order to
receive dental care form your Plan Provider. Your name will appear on an eligibility list, which is sent to your
selected dentist each month.

XI. Workers' Compensation Exclusion - Expenses for which payment is required under applicable Work-
ers' Compensation statutes are not eligible for payment under this dental plan.

XII. Coordination of Benefits - This Coordination of Benefits (COB) provision applies to this Plan when a
Member and/or Subscriber has other dental care coverages. In the event benefits apply under two or more dental
care coverages, each plan determines its order of benefits using the first of the following rules that apply:
     A. Non-dependent or Dependent. The plan that covers the person other than as a dependent, such as an
        employee, member, policyholder retiree or subscriber, is the primary plan and the plan that covers the
        person as a dependent is the secondary plan.
     B. Child Covered Under More Than One Plan. Unless there is a court decree stating otherwise, plans
        covering a child shall determine the order of benefits as follows:
        1. For a child whose parents are married or living together if they have never been married:
                a. The plan of the parent whose birthday falls earlier in the calendar year is the primary
                   plan; or
                b. If both parents have the same birthday, the plan that has covered the parent longest is the
                   primary plan.
        2. For a child whose parents are divorced or separated or are not living together if they have never
           been married:
                a.       i. If a court decree states that one of the parents is responsible for the child's
                            health care expenses or health care coverage, the responsible parent's plan is
                            primary.
                         ii. If the parent with responsibility has no health care coverage for the child's
                             health care expenses, but the spouse of the responsible parent does have
                             health care coverage for the child's health care expenses, the responsible
                             parent's spouse's plan is the primary plan.
                b. If a court decree states that both parents are responsible for the child's health care
                   expenses or health care coverage, the provisions of R590-131-6.B.1. shall determine the
                   order of benefits.
                c. If a court decree states that the parents have joint custody without stating that one parent
                   has responsibility for the health care expenses or health care coverage of the child the
                   provisions of R590-131-6.B.1. shall determine the order of benefits, or
                d. If there is no court decree allocating responsibility for the child's health care expenses or
                   health care coverage, the order of benefits for the child are as follows:
                         i. the plan covering the custodial parent;
                         ii. the plan covering the custodial parent's spouse;
                         iii. the plan covering the non-custodial parent; and then
                         iv. the plan covering the non-custodial parent's spouse.
                e. For a child covered under more than one plan, and one or more of the plans provides coverage for
                   individuals who are not the parents of the child, such as a guardian, the order of benefits shall be
                   determined under R590-131-6.B.1. or 2. as if those individuals were parents of the child.
     C. Longer or Shorter Length of Coverage.
        1. If the preceding rules do not determine the order of benefits, the plan that covered the person for the
           longer period of time is the primary plan and the plan that covered the person for the shorter period of
           time is the secondary plan.
        2.      a. To determine the length of time a person has been covered under a plan, two successive plans shall
                   be treated as one if the claimant was eligible under the second within 24 hours after coverage
                   under the first plan ended.
                b. The start of a new plan does not include:
                         i. a change in the amount or scope of a plan's benefits;
                         ii. a change in the entity that pays, provides or administers the plan's benefits; or
                         iii. a change from one type of plan to another, such as, from a single employer plan to a
                              multiple employer plan.


FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+                 7
               c. The person's length of time covered under a plan is measured from the person's first date of coverage
                  under that plan. If that date is not readily available, the date the person first became a member of the
                  group shall be used as the date from which to determine the length of time the person's coverage
                  under the present plan has been in force.
    D. If none of the above rules determine the primary plan, the allowable expenses shall be shared equally between
       the plans.
    E. If the plans cannot agree on the order of benefits within 30 calendar days after the plans have received all of
       the information needed to pay the claim, the plans shall immediately pay the claim in equal shares and deter
       mine their relative liabilities following payment, except that no plan shall be required to pay more than it
       would have paid had it been the primary plan.

XIII. Third Party Responsibility - In the event a Member and/or Subscriber sustains any illness or injury for
which a third party may be responsible, the Plan, up to the amount of benefits paid or provided, shall be entitled to the
proceeds of any settlement or judgement which results in a recovery from the third party; but only under the condi-
tions that the covered Member and/or Subscriber is made whole first.

XIV. Continuation of Coverage - You and your dependents are entitled to continue coverage, should you and/or
your dependents' eligibility under the Plan. You must provide written notification of request for continuation of cover-
age with appropriate membership dues (premium) within sixty (60) days of the date your eligibility ceases. For
continuation under the COBRA Act, if applicable, contact your Employer for details.

XV. Termination - Benefits under this Plan shall cease upon any of the following events:
       A. On the date of the expiration of the period for which the last payment was made.
       B. Upon the date of entry into full-time military service.
       C. On the last day of the month during which termination notice occurs, or thirty (30) days from the date that
          the termination notice is received by the Member and/or Subscriber, whichever date is later, in the event
          that a Member and/or Subscriber fails to maintain a satisfactory dentist-patient relationship, i.e. the Plan
          Provider no longer desires to treat the Member and/or Subscriber.
       D. In the event premiums are delinquent, services and benefits under the Plan shall be suspended effective on
          the last day of the month during which the delinquency occurred.
       E. On the date the Plan contract terminates, if not renewed.

XVI. Dental Records - The dental records of the Member and/or Subscriber concerning services performed
herein shall remain the property of the Plan dentist.

XVII. Customer Service Inquires - Plan Members and/or Subscribers customer service is available by calling
TDAUT at (801) 268-9740 or toll-free 1-800-880-3536 during normal business hours. All group dental plan inquires,
including grievance procedures are handled byTDA UT.

XVIII. Early Termination Penalty - While employed with the Group, the Subscriber agrees to remain enrolled as
a Member of the Group Dental Plan for a minimum of one year. Less than one-year membership may result in the
Subscriber being billed usual service fees minus premium and Co-payments paid.

XVIV. Proof of Loss - Written proof of loss must be given to Plan within 90 days after the date of the loss for which
encounter is made. If it was not reasonably possible to give written proof within the 90 day period, Plan will not reduce
or deny an encounter for this reason if the proof is filed as soon as is reasonably possible.




                                                              FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+                      8
                                   PRINCIPAL EXCLUSIONS AND LIMITATIONS

1. Sealants are covered to the age of fifteen (15) and are limited to once per permanent molars only.
2. Periodontal treatment (sub-gingival curettage and root planing) is limited to five quadrants in any thirty-six
(36) consecutive months.
3. Replacement of a restoration is covered only when it is dentally necessary.
4. Fixed bridgework shall be covered only when a partial cannot satisfactorily restore the case. If fixed bridges
are used when a partial could satisfactorily restore the case, it is considered optional treatment.
5. Replacement of existing bridgework is covered only when it cannot be made satisfactory by repair.
6. Partial dentures are not to be replaced within any five (5) year period from the date of last placement,
regardless if last placement occurred while covered under this Plan, unless necessary due to natural tooth loss
where the addition or replacement of teeth to the existing partial is not feasible.
7. Full upper and/or lower dentures are not to exceed one each in any five (5) year period from the date of last
placement, regardless if last placement occurred while covered under this Plan. Replacement shall be provided
by the Plan for an existing full or partial denture only if it is unsatisfactory and cannot be made satisfactory by
either reline or repair.
8. Denture relines are limited to two (2) in any year.
9. Services for injuries or conditions, which are covered under Workers' Compensation or Employers' Liability
Laws. Services, which, in the opinion of the attending dentist, are not necessary for the patient's dental health.
10. Services of a Pedodontist (children’s dentist) are not covered except as provided herein.
11. Services, which, in the opinion of the attending dentist are not necessary for patient’s dental health are not
covered.
12. Temporomandibular joint treatment (TMJ), except as provided herein.
13. Elective or cosmetic dentistry, except as provided herein.
14. Oral surgery requiring the setting of fractures or dislocations. Orthonognathic surgery or extractions solely
for orthodontic purposes.
15. Orthognathic surgery or extractions solely for orthodontic purposes are not covered.
16. Treatment of malignancies, cysts or neoplasms or congenital malformations, except congenital anomaly of a
tooth or teeth covered from birth, adoption or placement for adoption.
17. Dispensing of drugs is not covered.
18. Hospital charges of any kind are not covered.
19. Loss or theft of dentures or bridgework are not covered.
20. Any procedure of implantation or of an experimental nature, (i.e., a service, procedure, drug or treatment for a
specific diagnosis from the appropriate governmental regulatory body) are not covered.
21. General anesthesia or IV/conscious sedation, except as provided herein.
22. Fees incurred for broken or missed appointments (without 24 hours notice) are the Member's responsibility.
23. Dental expenses incurred in connection with any dental procedure started prior to the effective date of
coverage are the Member’s responsibility and are not covered.
24. Dental expenses incurred in connection with any dental procedure started after termination of eligibility for
coverage are the Member’s responsibility and are not covered..
25. Any procedure performed for the purpose of correcting contour, contact or occlusion, except as provided
herein, is not covered.
26. Any procedure to correct tooth structure lost due to attrition, erosion or abrasion.
27. Any procedure that is not specifically listed as a covered benefit is not covered.
28. Provider may refuse treatment to any patient who continually fails to follow a prescribed course of treatment.
29. Any dental treatment, which, in the opinion of the Plan's dental consultant has a poor prognosis is not
covered.
30. Night guard (occlusal guard) limited to one each twenty-four (24) months.
31. Services performed by a dentist who is not a Participating Dentist are not covered, except for emergency care
as provided herein.




FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+               9
                        ORTHODONTIC PLAN EXCLUSIONS AND LIMITATIONS

1. No benefits will apply for a treatment program which began before the
   Member/Subscriber enrolled in the Orthodontic Plan.
2. No benefits will apply for lost or broken appliances.
3. Extractions are not included as a benefit.
4. Additional fees, for which you are responsible, may be charged by the dentist for:
     a. Care required in excess of 24 months from the time of banding.
     b. Gross non-cooperation.
     c. Accidents occurring during the period of treatment.
     d. Cases involving surgical orthodontics.
     e. Cases involving myofunctional therapy of TMJ.
5. If the Member and/or Subscriber relocates to an area and is unable to receive treatment from a
   member Orthodontist, coverage under the Plan ceases and it becomes the obligation of the Member
   and/or Subscriber to pay the usual and customary fee of the Orthodontist where the treatment is
   completed.
6. Choice of an Orthodontist is limited to Orthodontists participating in the Plan or to Orthodontists
   who will accept the fees outlined in the Plan.
7. If the Member and/or Subscriber becomes ineligible for benefits under this Plan for treatment,
   coverage under the Plan ceases and it becomes the obligation of the Member and/or Subscriber
   to pay the remaining balance due the Orthodontist.




                                                         FORM NO. 610•DNTL.TOTALCAREBKLT (04/10)e+       10
                                      TDA-COMPANION



    THE TDA-COMPANION PLAN
This option allows you to go to any dentist or enjoy discounted fees from nearly 1600 dentists.
Preventative services, simple extractions, and basic fillings are covered at 100% after a one-time
lifetime deductible is met!

      Low monthly premiums:            Single    $36.26
                                       Two Party $76.23
                                       Family    $110.60




                              Sample Illustration of Savings
                         TDA-Companion versus No Dental Insurance

      Procedure (quantity)                TDA-              No Dental       Savings        Savings
                                       Companion            Insurance                        %
                                       Copayment*
    Exam & X-ray (2 per person)            $0.00              $872.00         $872.00        100%
    Cleaning (2 per person)                $0.00              $508.00         $508.00        100%
    Resin 2 Surface Filling (3)            $0.00              $360.00         $360.00        100%
    Crown, Porcelain with Metal (2)       $498.00            $1,388.00        $890.00        64%
    Office Visit Charge (16)               $0.00              $912.00         $912.00        100%
    Premium for 12 Months (Family)       $1,070.16             $0.00        -$1,066.20      -100%
               Total                   $1,568.16           $4,040.00      $2,471.84     61%**
      Sample based on typical family of 5
      *At a participating provider
      **Percentage of savings represents this illustration only. Actual savings may vary per
       individual treatment plan.


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                                                        TDA-COMPANION
                                                                   BENEFITS CONTINUED
Limitations
Covered Expenses Will Not Include and No Benefits Will Be Payable:                     13)        For subgingival curettage or root planing (procedure
1)     For major services in the first 12 months that the Insured is covered,                     numbers 4220 and 4341) unless the presence of
       except as may be provided in the Takeover Benefits provision.                              periodontal disease is confirmed by both x-rays and
2)     For any treatment which is for cosmetic purposes or to correct                             pocket depth summaries of each tooth involved.
       congenital malformations, except for medically necessary care and               14)        Because of an Insured’s injury arising out of, or in the
       treatment of congenital cleft lip and palate.                                              course of, work for wage or profit.
3)     To replace any prosthetic appliance, crown, inlay or onlay restoration, or      15)        For an Insured’s sickness, injury or condition for which he
       fixed bridge within five years of the date of the last placement of these                  or she is eligible for benefits under any Worker’s
       items, unless required because of an accidental bodily injury sustained                    Compensation act or similar laws.
       while the Insured is covered. Replacement is not covered if the item can        16)        For charges for which the Insured is not liable or which
       be repaired.                                                                               would not have been made had no insurance been in
4)     For initial placement of any prosthetic appliance or fixed bridge unless                   force.
       such placement is needed because of the extraction of natural teeth             17)        For services which are not recommended by a dentist,
       during the same period of continuous coverage. But the extraction of a                     not required for necessary care and treatment, or do not
       third molar, (wisdom tooth) will not qualify the item for payment. Any                     have a reasonable prognosis.
       such appliance or fixed bridge must include the replacement of the              18)        Because of war or any act of war, declared or not, or
       extracted tooth or teeth. Coverage does not include the part of the cost                   while on full-time active duty in the armed forces of any
       that applies specifically to replacement of teeth extracted prior to the                   country.
       period of coverage.                                                             19)        To an Insured if payment is not legal where the Insured is
5)     For addition of teeth to an existing prosthetic appliance or fixed bridge                  living when expenses are incurred.
       unless for replacement of natural teeth extracted during the same period        20)        For any services related to: equilibration, bite registration
       of continuous coverage.                                                                    or bite analysis.
6)     For any expense incurred or procedure begun before the Insurer’s                21)        For crowns for the purpose of periodontal splinting.
       current period of continuous coverage.                                          22)        For charges for: any implants; overdentures; precision or
7)     For any expense incurred or procedure begun after the Insured’s                            semi-precision attachments and associated endodontic
       insurance under this section terminates, except for a prosthetic                           treatment; other customized attachments; or specialized
       appliance, fixed bridge, crown, or inlay or onlay restoration for which                    prosthodontic techniques or characterizations.
       both (a) the procedure begins before the insurance ends and (b) the             23)        For charges for myofunctional therapy, orthognathic
       item’s final placement is within 90 days after insurance ends.                             surgery or athletic mouthguards.
8)     To duplicate appliances or replace lost or stolen appliances.                   24)        For procedures for which benefits are payable under the
9)     For appliances restorations or procedures to:                                              employer’s medical expense benefits plan for employees
    a) Alter vertical dimensions;                                                                 and their dependents.
    b) Restore or maintain occlusion
    c) Splint or replace tooth structure lost as a result of abrasion or attrition;
          or                                                                                 Predetermination of Benefits: As a service to protect the insured,
    d) Treat jaw fractures or disturbances of the temporomadibular joint.                    Companion Life will provide predetermination of benefits for
10)    For educational training in, and supplies used for, dietary or nutritional            recommended treatment plans that exceed $300. This predetermination
                                                                                             of benefits explains which of the recommended procedures will be
       counseling, personal oral hygiene or dental plaque control.                           covered and at what amount. This benefit helps insured better
11)    For broken appointments or the completion of claim forms.                             understand their coverage. The insured should submit the treatment
12)    For sealants which are:                                                               plan to Companion Life for review and predetermination of benefits
    a) Not applied to a permanent molar;                                                     Monthly Premium:
                                                                                             before the service begins.
    b) Applied before age 6 or after attaining age 16;or                                     Single              $36.26
    c) Reapplied to a molar within three years from the date of a previous                   Two-Party           $76.23
          sealant application. Frustrating                                                   Family              $110.60
_____________________________________

                                                                                                                   Underwritten by:
                     Administered and Marketed by:                                                       Companion Life Insurance Company
                    Total Dental Administrators, Inc.                                                              P. O. Box 10012
                969 East Murray Holladay Rd., Suite 4E                                                        Columbia, SC 29202-3102
                       Salt Lake City, Utah 84117                                                        (800) 753-0404 – Fax (803) 735-0736
          (801) 268-9740 – (800) 880-3536 – Fax (801) 268-9873                                              Rated Excellent by A.M. Best




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