1 PPO Products and services marketed by Assurant Employee Benefits are underwritten or provided by Union Security Insurance Company. Prepaid Products and services marketed by Assurant Employee Benefits are underwritten and/or provided by United Dental Care of Arizona, Inc.

2008 Dental Plan Options for Arizona State Retirement System

About Us Fortune 500 Company Financial Ratings*: A (Excellent) A.M. Best A2 (Good) Moody’s A (Strong) Standard and Poor’s Assurant, Inc. is a Fortune 500 company and a member of the S&P 500 Index. Assurant Employee Benefits is a part of Assurant, Inc. *Ratings for Union Security Insurance Company

4 Dental Plans-2008 Freedom Advance ℠ (high option) Freedom Basic ℠ (low option) Prepaid – Heritage Secure Plan Plans contain limitations, exclusions, and restrictions. Please review the certificate booklet and group policy or Evidence of Coverage for complete details and provisions.

Type I - Preventive Services80% paid Oral exams deductible waived Routine cleanings X-rays Type II - Basic Services 80% paid Fillings deductible applied Minor and major periodontics Root canals, minor oral surgery Freedom Advance ℠ (High Option)

Type III - Major Services 25 or 50% paid transfer credit applies Crowns deductible applied Bridges Dentures Complex Oral Surgery Orthodontia not covered Maximum Benefits $2,500 per person Annual combined preventive, basic and major

Type I - Preventive Services 100% paid Oral exams deductible waived Routine cleanings Bitewing x-rays Type II - Basic Services 80% paid Fillings deductible applied Minor periodontics Minor oral surgery Other x-rays Freedom Basic ℠ (Low Option)

Type III - Major Services not covered Orthodontia not covered Maximum Benefits $1,000 per person Annual combined preventive and basic

9 Predetermination of Benefits Recommended for treatments over $300.00

Freedom Indemnity Dental Plans include Dental Health Alliance PPO Discounts on covered and non- covered procedures including cosmetic services No balance billing DHA is our PPO network name

Freedom Indemnity Plans Customer Service Number Business Hours to assist you: 7:00a.m. - 5:00p.m. CT Monday - Friday

Prepaid Plans Secure Plan (Arizona) with Specialty Benefit Amendment may select other states where available

Prepaid Plan Features No deductibles No claim forms to file 1 No annual dollar maximums No waiting periods for services Coverage for pre-existing conditions Emergency coverage 2 Cosmetic dentistry 1 Proof of expenses are required when seeking reimbursement for emergency services performed by a non-plan provider. 2 Emergency benefits in your plan are limited to the temporary relief of pain.

Arizona Secure Plan sample copayments for selected family dentist Procedure D0999 Routine Office Visit $10.00 D1110 Prophylaxis - Adult $10.00 Cleaning (Semi-Annually) Member Copay ADA Code

Copayments cont. ADA Code Procedure Member Copayment D2750Crown - PFM $ (Lab Fee Additional) D3310Root Canal - Anterior $ D5110Complete Upper Denture$ (Lab Fee Additional)

Member Copayment to Specialist- SBA plan specialists are indicated with an “S” in the provider directory 15%-25% discount if procedure is NOT listed on Specialty Benefit Amendment 25% discount on Orthodontic Services (Adult and Child) No Referral Required No Annual Dollar Maximums Prepaid Plan Specialty Benefit Amendment

Prepaid Plan Directory of Dentists Ability to change dentists Each family member may select a different dentist Click on “Provider Search” Select Heritage Series

Prepaid Plan Customer Service Business hours to assist you: 7:00 a.m.-5:00 p.m. CT, Monday-Friday Automated Eligibility System Business hours to assist you: 7:00 a.m.-7:00 p.m. 7 days per week

Vision Service Plan (VSP) (included with all dental plans) Discounts on exams, eyeglasses, laser vision care, contact lens exam, sunglasses No waiting periods No deductibles No claim forms to fill out VSP Customer Service

Online Advantage for Members View eligibility Change facility for prepaid members View benefit details Dental fee cost estimator View claims status Ask a dentist Find a dentist and/or specialist Dental health center Request ID card Contact customer service For more information about how Online Advantage can work for you please visit the online demo a call customer service at or

On-Site Representative Monday - Friday, 8:00 a.m. - 5:00 p.m. MT , ext. 2032

This presentation provides a summary of the plans offered to the Arizona State Retirement Systems. Please review the certificate booklet and group policy or the Evidence of Coverage for complete details and provisions. Plans contain limitations, exclusions, and restrictions. Contact Assurant Employee Benefits for more information.

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