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Plan deductible The deductible is waived for diagnostic & preventive services. Individual $50.00 /yr Family $150.00 /yr Claims Information Beam Insurance Administrators Electronic payer ID NEA ID Fax number Phone number Claim form accepted PO Box 75372 BEAM1 BEAM1 (844) 688-4821 (800) 648-1179 ADA form 2006 or later Cincinnati, OH 45275 Beam Dental PPO Standard coverages, as of August 1, 2019 Questions? If you have questions, call us at (800) 648-1179. We'd love to help! Or visit app.beambenefits.com and login to view more info. Please check your Certificate of Insurance for a description of coverage, limitations, and exclusions under the plan. Some services require prior authorization. FIND A DENTIST QUESTIONS? CHECK CLAIMS & ELIGIBILITY dentists.beambenefits.com [email protected] providers.beambenefits.com BM-SOB-0035-202306 Valid as of 10/01/24 2 of 3

Dental Benefits Summary   SmartPremium 100 80 50 2 - Page 2 Dental Benefits Summary SmartPremium 100 80 50 2 Page 1 Page 3