1. Dental coverage Smile….. 11

2. What is covered? 100% coverage for Preventive Cleanings Xrays Exams Sealants through age 13 Paid at Lewiston rates. There could be some balance billing for some dentists. 2

3. What is covered? 80% coverage for Restorative Fillings Root canals Scaling Oral surgery Paid at Lewiston rates. There could be some balance billing for some dentists. 3

4. What is covered? 60% coverage for Major Restorative Bridges Crowns Dentures Paid at Lewiston rates. There could be some balance billing for some dentists. 4

5. What is covered? 50% coverage for Orthodontics Subject to $1000 lifetime maximum Available for children Available for adults 5

6. Miscellaneous Other features of the dental plan: Deductible applies to Restorative and Major Restorative levels ($25/individual and $75/family) No dental network… so go to any dentist If you can’t find a dentist, you might call Community Dental at 874-1025 or visit them at www.communitydental.com 6