Select Choice and Direct Reimbursement Plan

ODS is pleased to announce two new dental products. These new dental products are innovative approaches to self-funding employee dental benefits to groups of 51 or more enrolled subscribers.

The two products are similar in appearance, however have some definite differences. The first new product (previously introduced to you in a special bulletin notification in April, 1999) is known as DIRECT Reimbursement and is offered through BenefitHelp Solutions, affiliate of ODS.

These products are strongly supported by the American Dental Association, as well as the Oregon Dental Association as an alternative to traditional style dental plans.

One of the most attractive features of the DIRECT Reimbursement dental plan is its simplicity of operation. Under the DIRECT Reimbursement plan, the employee and covered dependents visit the dentist of their choice, receive necessary treatment and pay the dentist bill directly to the dental office. The employee then submits a simplified claim form to BenefitHelp Solutions for reimbursement. BenefitHelp Solutions reimburses the employee for the appropriate amount based on the benefits and maximums selected by the employer. BenefitHelp Solutions bills the employer (contract holder) for reimbursement of claim payments and administrative costs.

The second new dental product is known as SELECTChoice and is administered by ODS. The SELECTChoice product plan design mirrors the plan design for DIRECT Reimbursement, however the participating filed fee arrangements with the Delta Dental Premier professionals are utilized. Participating dentists will bill ODS direct, and reporting is available.

With both products, the benefits are simply stated as a maximum dollar limit per year per eligible individual or a percentage thereof. Reimbursement is based on dollar expenditures rather than on services incurred. Unlike conventional plans, there are typically no exclusions (except cosmetic services) and few, if any limitations on specific treatments or services.

With DIRECT Reimbursement and SELECTChoice the group sponsor is placing the responsibility for the best use of limited dollars available on the employee. Additionally, employees are involved in the cost containment process with cost-sharing provisions such as annual maximums and copayments.

DIRECT Reimbursement and SELECTChoice dental products are marketed through your ODS marketing team. For more information regarding these products, please feel free to contact your marketing representative.