Odessa School District Dental Benefits Effective July 1, 2014 Opportunity to make changes/enroll Base & Buy-Up Plans Buy-Up plan includes a $1500 annual benefit maximum and 100% coverage for Diagnostic & Preventive Services in or out of PPO network Both plans continue to include access to both Delta Networks — Delta Dental PPO & Delta Dental Premier

Selecting a Dentist Delta Dental PPO and Delta Dental Premier Dentists  Delta Dental Contracted Provider  Discounted Fees In-Network**  No Balance Billing  No Claim Forms  Direct Dentist Reimbursement **Discounts are deepest in the PPO network Non-Network Dentists  Not Under Contract With Delta  No Discounted Fees  Balance Billing is Possible  Not Obligated To File Claims  Patient Reimburses Dentist Network Status of Odessa Dentists: Dr. Jerry Haney - Delta Dental PPO Network Dr. Scott Heriford - Delta Dental PPO Network

Base Plan Delta Dental PPO Network Dentist Delta Dental Premier Network Dentist Non-Network Dentist Deepest Discounts No balance billing Discounts No balance billing No Discounts Balance billing is possible Co-Insurance (Plan Pays) Diagnostic and Preventive Services100%80% Basic Restorative Services80% Major Restorative Services 50% Child Orthodontic Services (to age 19) 50% Calendar Year Deductible$50 per person / $150 family limit Applies to:B & C Services Calendar Year Benefit Maximum$1,000 per person Separate Lifetime Orthodontic Maximum $1,000 per eligible dependent child Dependent Age LimitEnd of the calendar year in which your dependent turns 26 This is intended to be a summary only. Refer to the Dental Benefit Highlights document provided in your handout for more detail on services covered under each class and plan limitations.

Buy-Up Plan Delta Dental PPO Network Dentist Delta Dental Premier Network Dentist Non-Network Dentist Deepest Discounts No balance billing Discounts No balance billing No Discounts Balance billing is possible Co-Insurance (Plan Pays) Diagnostic and Preventive Services100% Basic Restorative Services90%80% Major Restorative Services60%50% Child Orthodontic Services (to age 19) 50% Calendar Year Deductible$50 per person / $150 family limit Applies to:B & C Services Calendar Year Benefit Maximum$1,500 per person Separate Lifetime Orthodontic Maximum $1,000 per eligible dependent child Dependent Age LimitEnd of the calendar year in which your dependent turns 26 This is intended to be a summary only. Refer to the Dental Benefit Highlights document provided in your handout for more detail on services covered under each class and plan limitations.

Technology Live reps from 7am to 5pm Monday through Friday Benefit24 VRU (Virtual Response Unit) –Faxback – summary of benefits your questions Self-serve website Questions?

Technology Self-serve features: –Network provider search –Claims status and history –Copy of EOB –Benefit design –Track use of maximums –Print ID cards –Request an ID card