DINA Dental

DINA Dental Insurance is available to eligible new employees to enroll within 30 days of their hire date. Other eligible employees may enroll at anytime during the year. There are two levels of coverage:

Pre-Paid Plan features:

• The plan focuses on preventive and diagnostic services
• You must select a provider from the list of contracted dentists
• No deductible
• No annual maximum
• No claim forms
• Co-payments for most services
• Orthodontics (Children under age 21) (Participating Ortho ONLY) Initial Consultation covered at 100%, treatment covered at 20% discount.

Indemnity Plan features:

• The plan focuses on preventive and diagnostic services
• Choose from a list of contracted dentist for the greatest savings
• Can use non-contracted dentist - benefit paid same as contracted or less
• 1st year - $50.00 deductible for Preventive and Basic Services
  Major Services not covered first year
• 2nd year - No deductible for Preventive Services
  $50.00 deductible for Basic and Major Services
• Annual Maximums
  • 1st year - $750
  • 2nd year - $1,000
  • 3rd year - $1,500
• Preventive Services are payable at 100% of scheduled charge (after deductible)
• Basic Services are payable at 80% of scheduled charge (after deductible)
• Major Services are payable at 50% of scheduled charge (after deductible)
• Orthodontics (Children under age 21) (Participating Ortho ONLY) Initial Consultation covered at 100%, treatment covered at 20% discount.

DINA Prepaid
Level	Monthly	Bi-Weekly	10 Pay FAC
Single	$13.00	$6.50	$15.60
Emp + 1	$21.00	$10.50	$25.20
Family (3 or more)	$28.00	$14.00	$33.60

DINA Indemnity
Level	Monthly	Bi-Weekly	10 Pay FAC
Single	$20.00	$10.00	$24.00
Emp + 1	$38.00	$19.00	$45.60
Family (3 or more)	$60.00	$30.00	$72.00

Contact your local DINA agent 1-800-376-3462 or (225) 291-3172 or you can enroll by visiting the Human Resources Office.

For more information visit DINA's website at http://www.dinadental.com/