Delta Dental of New Mexico 

1. Dental Plan BenefitsAugust, 2010 Administered by Delta Dental of New Mexico Oral Health is Our Passion Quality Benefits, Quality Dentists Oral Health is Our Passion Quality Benefits, Quality Dentists Oral Health is Our Passion Quality Benefits, Quality Dentists Oral Health is Our Passion Quality Benefits, Quality Dentists Delta Dental of New Mexico Delta Dental of New Mexico Delta Dental of New Mexico Delta Dental of New Mexico … administering the dental program for … administering the dental program for … administering the dental program for … administering the dental program for State of New Mexico State of New Mexico State of New Mexico State of New Mexico General Services Department General Services Department General Services Department General Services Department Risk Management Division Risk Management Division Risk Management Division Risk Management Division

2. UNM Hospitals Dental PlanProvider Network Overview – Point-of-Service Plan One Plan, two network choices! Plan Participants can select any dentist in either the Delta Dental Premier or Delta Dental PPO network at the time dental services are received. Over 1,180 points of access in New Mexico 817 points of access in New Mexico Over 138,900 dentist locations nationally Almost 220,000 dentist locations nationally Log on to deltadentalNM.com to search for a dentist.  Pre-selection of a dentist is not required and every member of your family may visit a different dentist.  There is no need to contact Delta Dental to change your dentist; you may change as often as you like.  Whenever possible, use in-network dentists. Lower out-of-pocket costs, and important member protections apply when services are received in-network!

3. UNM Hospitals Dental PlanDental Plan Benefits Overview • Calendar Year Deductibles • $50 per enrolled person $150 aggregate per family • Does not apply to Diagnostic & Preventive Services • Does not apply to Orthodontic Services Calendar Year Maximums • $1,200 per enrolled person per benefit period Separate Lifetime Maximums apply to Orthodontic Services

4. UNM Hospitals Dental PlanDental Plan Benefits Overview Out-of-network dentists may balance bill patients for amounts over Maximum Approved Fees.

5. UNM Hospitals Dental PlanOrthodontic Benefit Overview Out-of-network dentists may balance bill patients for amounts over Maximum Approved Fees.

6. UNM Hospitals Dental PlanPredetermination of Benefits

7. UNM Hospitals Dental PlanSpecial Eligibility Provisions

8. UNM Hospitals Dental PlanInformation Available 24/7! • Enrollees have online access to personalized benefit information, oral health information,privacy policies and more. No software to purchase or download required. • Featured Plan Information Available at deltadentalnm.com in the Subscriber Section • Subscriber Materials are accessed with the UNMH group number (4101). • Enrollees may view, print, or save coverage documents: • Summary of Benefits • Dental Benefit Plan Provisions • Provider Directory • Consumer Toolkit • Enrollees may also select Consumer Toolkit and sign in to: • Verify eligibility of subscriber and dependents • Confirm status of deductibles and plan maximums • Review how a specific claim was processed • Print a personalized subscriber ID card www.deltadentalNM.com

9. UNM Hospitals Dental PlanCustomer Service • Dental plan claims and administration services provided in New Mexico • Experienced Benefit Representatives • Available Monday – Friday 8:00am-4:30pm • Albuquerque 505-855-7111 • Toll free 1-877-395-9420 • Over 95% of calls answeredin fewer than 45 seconds

10. UNM Hospital Dental RatesPer Pay Period(24/Year)