Delta Dental of Kansas Community Benefit Program Pat Delta Dental of Kansas Community Benefit Program 1

Benefit Plan Details DDKS is covering up to $3,000 in dental claims.  Any treatment/claims over the $3,000 annual maximum will be the responsibility of the dental office and/or patient. 100% Diagnostic and Preventive, 100% Basic, 100% Major coverage $3,000 annual maximum $5.00 per person/$10.00 per family yearly deductible Patients can visit ANY in-network Delta Dental provider. Waiting periods waived Frequencies and limitations are waived on all services, including Diagnostic & Preventive services Sarah 2

Benefit Plan Details Diagnostic & Preventive services will count towards the annual maximum. Dependents covered up to age 26 12 month program (i.e. if an individual is eligible in November 2019, they will have coverage until November 2020) Individuals are eligible for coverage for 2 years, but United Way will verify eligibility requirements on an annual basis. Not covered: braces (orthodontics), TMJ, cosmetic, implants, harmful habit appliances, occlusal guards or out of country claims Sarah 3

Sarah

What are the eligibility requirements? Families with income less than or equal to 250% of the federal poverty line. Head of household must be employed. Family members do not have access to dental insurance by more traditional means, e.g., employer, eligibility as a dependent, state of residence. Those enrolled in governmental dental programs are eligible for enrollment. Year Two: Renewal coverage applicants must meet criteria listed above and must have utilized the program by at least one family member during the prior year. Pat As you think of individuals for this program, look for individuals who are in need of dental care. 5

How do individuals enroll? Fill out the Enrollment Form, the Consent to Release Information Form and the Agency Confirmation Form Via email at dental@unitedwayplains.org Via fax to 316-267-0937; attention Dental Pat 6

What happens next? United Way will verify eligibility and notify the agency contact of approval/denial. If approved, the eligibility date will be provided along with a Welcome Brochure that may be printed and provided to the individual. The agency contact will then notify the individual of approval/denial. The approved individual will receive a Delta Dental ID Card in the mail. Once eligible, the individual(s) may visit the dentist. Pat 7

Helping You Educate https://deltadentalks.co m/groups/united-way DeltaDentalKS.com/UnitedWay https://deltadentalks.co m/groups/united-way

Questions? 9