Labor Fund Dental Network Program

1. Labor Fund Dental Network Program A Dental PPO National Network for Taft-Hartley Health and Welfare Funds

2. Program Overview • Allows Taft-Hartley Health and Welfare Funds access to a National Dental PPO Network • Easy access to nationwide providers for members • Utilizes the National Dental PPO Network of contracting providers to realize valuable savings for dental services with discounts ranging from 25-40% below the usual and customary charges • Claim administration may be handled by the Fund office • Access Fee charged per member per month (PMPM) based on group size

4. Top States in Total Network Providers As of 01/2006

5. Labor Fund Dental PPO Network This program provides nationwide access to providers through both the Dental Network of America (DNoA), a subsidiary of Health Care Service Corporation (HCSC), which operates Blue Cross and Blue Shield of Illinois, and DenteMax, a wholly owned subsidiary of Blue Cross and Blue Shield of Michigan.

6. Fund Fund maintains control of key member functions Adjudicates claims per its benefit plan Verifies eligibility Handles member contact and inquiries Issues EOBs Can create ID Cards BCBSIL Provides access to national dental PPO network Network manager handles provider inquiries about fee schedules Provides member education communications for Funds to distribute Integrated account management Can create ID Cards For an additional fee, can provide dental claim review, and actuarial and dental plan design consultation Features of the Program

7. How the Program Works The provider submits the claim to the Fund office. The member receives dental services. The Fund office verifies eligibility and benefit level, adjudicates the claim based on the network file and fee schedule, sends the member EOB and pays the provider. The Fund office responds to member inquiries.

8. To the Fund Access to national PPO dental network In-network utilization delivers plan savings One ID card may be used for medical and dental Ease of implementation To the Member Nationwide provider access Customer service by the Fund’s administrative office No balance billing when PPO providers are utilized ID card recognized nationwide Can find network providers coast-to-coast through www.dnoa.com Benefits of the Program

9. Dental Options for Cost Savings Passive PPO: PPO: • Benefits are paid at the highest level and member out-of-pocket costs are lower when services are received from in-network dentists • When members use in-network dentists, there are no claims to file and no balance billing • When out-of-network providers are used, benefits are paid at the lower benefit level and non-network dentists can be paid at the same discounted rate as network dentists • Benefit levels remain the same for both in-network or out-of-network services • There is no disruption to the member • When PPO providers are utilized, there is no balance billing • Out-of-network claims are paid at usual and customary (U&C) charges

10. A Commitment to Delivering Value to Fund Accounts The Labor Fund Dental Network Program gives you… • Member access to a broad national network of dental PPO providers • Savings realized by the Fund and members through network utilization and competitive fee schedules • Competitive Access Fee pricing arrangements • Easy program start-up and maintenance • Integrated account management

11. Next Steps If you are interested in further analysis of your Fund, we can provide: • Claims re-pricing • Estimate of cost savings • Geo Access reports • Disruption analysis For more information, please contact the Labor Affairs department at 312/653-8635