Benefits Overview

*Average dental savings are 25%
based on national average.

Affordable Discount Dental

Network size: 80,000+ Access Points

Members and their family can save up to 60%* on quality dental care through our large network of dentists. You can save on routine dental services such as exams, cleaning, x-rays, fillings, simple extractions, crowns, root canals, dentures, bridges, oral surgery, orthodontics, periodontics, cosmetic dentistry and teeth whitening.

There are no claim forms, deductibles or reimbursement procedures. Your savings are received immediately at the point of service. There are 80,000+ access points nationwide, which makes this one of the largest networks of its kind in the country.

Since this dental program is not insurance, you do not have to worry about any deductibles. You save from the first dollar with no limits. This program can also help you save on any out of pocket expenses for services that are not covered under any other dental plan you may have.

Routine 6 Month Check-Up In Depth Check-Up Full Mouth X-Rays Bitewings Four Films Panoramic Film Adult Cleaning Child Cleaning Sealant Per Tooth White Filling Crown

Porcelain Crown Porcelain Fused to Noble Metal Core Build-Up, Including Any Pins Root Canal - Anterior Root Canal - Bicuspid Root Canal - Molar Perio scaling and root planing (per quadrant) Upper Denture (Complete) Tooth Replacement / Bridge Prosthetic Single Tooth Extraction

Code	Procedure	Typical Dentist Fee	Select Dental Advantage Fee	Savings
D0120	Periodic Oral Exam	$37	$22	40%
D0150	Comprehensive Oral Evaluation	$63	$33	48%
D0274	Bitewings X-Rays - four films	$50	$29	41%
D0330	Panoramic X-Ray	$89	$57	36%
D1110	Adult Cleaning	$67	$43	36%
D2140	One Surface Silver Filling	$108	$56	48%
D2331	Two Surface Composite Filling	$148	$85	43%
D2750	Crown-Porcelain/High Noble Metal	$902	$590	35%
D3330	Root Canal (molar)	$928	$555	40%
D4210	Gum Surgery (per quadrant)	$784	$330	58%
D5110	Complete Upper Denture	$1,186	$680	43%
D5214	Partial Lower Denture	$1,311	$740	44%
D7230	Extraction - Partially Bony	$357	$196	45%

These fees are representative of the fees charged by network dentists, however, actual fees may vary by dentist by region. Please confirm the fees with the office prior to commencing treatment.

Typical plan benefits include:

• Cost Containment: A savings of 10% - 60% is given on quality dental care servives include General Practice, Oral Surgery, Orthodontics, Periodontics, Cosmetic Dentistry and Teeth Whitening Procedures.
• Quality: Preferred providers are certified or otherwise qualified by the states in which they practice.
• Convenience: The Dental PPO network is comprised of over 80,000 access points, simply select a provider and present the card. There are no pre-approvals, claim forms or reimbursements involved.
• Choice of Providers: Absolute freedom of choice within the network as to which provider to see.
• No Restrictions or Limitations: Members are entitled to use the benefit to purchase as many services as they need, as often as they desire.

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This program is not insurance. It is a discount program. You are responsible for the full cost of any dental related services purchased. You will receive discounts between 10%-60 for dental services at certain health care providers who have contracted with the program. Members have the right to cancel registration within a thirty day period with written proof that member was not able to receive such benefits as described in membership material within a reasonable amount of time. This program does not make payments directly to health care providers. A list of all program providers within the respective member’s service area which includes their name, city and state, and practice speciality is available prior to purchase. This program is administered by Select Benefits Global Marketing Corp., 105 Walnut Street, Lawrenceburg, IN 47025, 888-636-2378, www.selectbenefits.net. This program and its administrators have no liability for providing or guaranteeing service or the quality of services rendered.