Dental 4 Everyone

The New Voluntary Dental Plan for Member of Benefits Association, Inc.

Association members include:

Individuals: Premium payment by convenient monthly bank draft or credit card.
Small Employers: Can be payroll deducted down to 3 lives.
Senior Citizens: No age limits; premium payments by convenient monthly bank draft or credit card.

Monthly New Enrollee Rates
State & Zip Code (first 3 digits)	Member	Member & 1	Member & Family
Texas (except 770-777)	$45.15	$85.50	$123.00
Texas (770-777)	$49.75	$94.15	$138.75
Louisiana (except 710-714)	$45.15	$85.50	$123.00
Louisiana (710-714)	$49.75	$94.15	$138.75
Utah	$45.15	$85.50	$151.75

Rates include $3.00 billing fee, and $1.00 Association Dues

Your Deductible	Plan Pays 1st year	Plan Pays 2nd year	Plan Pays 3rd year
Type 1 $50.00 per person per year for Types 1, 2, & 3 procedures	80%	90%	100%
Type 2 See above.	60%	70%	80%
Type 3 See above.	0%	40%	50%
Type 4 $100 lifetime	0%	40%	50%

Services Covered:
Type 1 - Diagnostic and Preventive Treatment Diagnostic: Routine periodic examinations once in a 6 month period. Preventive: Dental prophylaxix (teeth cleaning and scaling) once in a 6 month period (including application of topical flouride for dependent children only.) Radiography: Bitewing x-rays once in a 6 month period. Full mount x-rays once in a 36 month period. Type 2 - Basic Procedures (6 month waiting period) Restorative: Amalgam, synthetic porcelain or plastic fillings. Oral Surgery: Extractions and other oral surgery, including pre and post operative care. Other: Space maintainers, recementation of crowns. Type 3 - Major Procedures (12 month waiting period) Endodontics: Pulpal therapy and root canals. Periodontics: Treatment of diseases of the gum. Prosthetics: Gold restorations, crown, bridges, partial and complete dentures.For enrollees of age 65 or older this benefit if limited to $600 per person per year. Other:* Pontics, repair of crowns and bridges, full and partial denture repair. Type 4 - Orthodontia Procedures (12 month waiting period) This benefit only applies to covered dependent up to age 19 (excerpt for age 21 in Louisiana and age 25 in Texas). ($350 benefit year maximum)($1,000 lifetime maximum per person for this benefit).

	Plan Features
	Free choice of dentist (however, Delta Dental Participating Dentists have agreed to file the claim for you and to accept the amount approved by Delta.)
	No age limitations
	$100 per person lifetime deductible on Ortho
	Policy year maximum $1200 per person
	6 month waiting period for Basic Care
	12 month waiting period for major care & Ortho
	Keep your dental plan regardless of your age
	Ortho benefits for dependents included at no extra charge
	Benefits increase after the first and second years
	No questions about your past dental history

This coverage is underwritten by Delta Dental Insurance Company, Rated "A" Excellent by A. M. Best,
the most recognized insurance rating agency.
Delta Dental Insurance Company 1431 Greenway Drive, Suite 520, Irving, Texas 75038
For additional information, an application or brochure, email:
Benefit Writers at sales@benefitwriters.com or call 1-888-888-5595
Access Delta Dental's National Dentist Directory on the Internet at www.deltadentalins.com

DDIC-BAI-ENR	Agent Name	Diane E. Vickers
1220	Agent #	1076022-Texas
Benefit Writers	P O Box 651	Rockwall, TX 75087

Benefits Association As a member of Benefits Association you receive the following Benefits and Services:
PreScrip		Discount prescription program
Avesis		Discounts on comprehensive hearing exams and hearing aids
Vision One		Eyecare Program
Budget		Car Rental discounts
The Worldnet		Worldwide travel assist program
Vitamins		Nutritional supplements
United Van Lines		Discount moving services
PowerNet		Discount long distance rates

If you have questions or comments, please contact Benefit Writers
9:00 am - 5:00 pm
214-607-1101 Toll Free: 888-800-9658
sales@benefitwriters.com
Monday - Friday, CST