Page 10 Provider network You can choose from one of the 132,000 credentialed providers at any of the 600,000 access points nationwide in the Equitable Dental Network. You can locate an in-network provider by visiting: . Using a www.equitable.com/finddentist network dentist will significantly lower your out-of-pocket expense because these dental professionals have agreed to provide covered services at discounted fees. Equitable does not contract directly with dentists. Equitable’s dental network is supported by several partner companies which may vary by state. This information is provided on our website at . www.equitable.com/dentalprovider Please reference the following network names when confirming in-network participation with your provider. • Careington • Dental Benefit Providers (DBP) • Dentemax Plus • HealthSmart • PPO USA Connection Dental Network (GEHA) • Total Dental Administrators (TDA) • Zelis Dental Network • United Concordia AdvantagePlus Out-of-network dentists have the right to balance bill members for the difference between the provider charge and our maximum allowable charge. Out-of-network dentists are not obligated by contractual agreement to submit claims on behalf of members. Claim forms may be requested by contacting the telephone number or email address indicated on your ID card or above. Understanding your benefits Commonly Used Terms Standard Benefit Waiting Period A dental insurance waiting period is a set period before you receive coverage for some specific dental procedures. Waiting periods vary based on your plan. Please refer to your certificate of insurance for any associated waiting periods (e.g., 6 months). In-Network Provider Dentists who have agreed to provide dental services at discounted rates for participants. Because your plan has a Passive PPO ,you can save up to 34% on average off of provider change by visiting an in network provider. You will not be liable for the difference between the discounted rate and the provider charge if you visit an in-network provider. Out-of-Network Provider Dentists who have not agreed to provide dental services at discounted rates for participants. You are free to visit out-of-network providers, but you may be balance billed for the difference between our allowed amount and the provider charge. Annual Individual Maximum Annual maximum for each individual covered under the plan for procedures other than orthodontia. Lifetime Orthodontia Maximum Maximum for orthodontia procedures which pays up to the maximum over a lifetime including treatment covered under other dental plans. Frequently Asked Questions When can I enroll? You can enroll when you are initially eligible for benefits and during any subsequent annual enrollment period defined by your employer or if there is a life status change, such as involuntary termination under another policy. • • • • • • • •