United Concordia

The annual benefit is 1,200 and the lifetime orthodontic maximum at $1,500. Sealants on permanent bicuspids are no longer covered, but full mouth debridement, implant coverage, frenulectomy and frenuloplasty have been added to the contract. Specific information regarding all benefits is available in the TDP Dental Reference Guide.

The chart below highlights the more noteworthy changes.

Benefit	2006 Contract
Bicuspid Sealants	Not covered
Implants and Implant Prosthetic Services	Covered at 50% Subject to $1,200 annual maximum Not covered when placed for a removable denture Not covered for patients under age 14 unless submitted with x-rays and approved by a United Concordia Dentist Advisor Replacement limited to once per five years
Full Mouth Debridement	Covered once per 24-month period.
Frenulectomy and Frenuloplasty	Covered. Considered integral when provided on the same day, by the same dentist as a frenuloplasty/frenulectomy or periodontal surgery.

Additionally, beginning with treatment plans starting February 1, 2006 and after, orthodontic payments will be made on a quarterly basis throughout the course of treatment. Payments will continue until the maximum is met or you notify us that the treatment is discontinued.

The level of TDP coverage remains unchanged as outlined in the following chart. Please note that the TDP provides coverage for selected services at a higher level for pay grades E–1 to E–4. These include endodontic, periodontic and oral surgery services.

Benefit Category	E1–E4	All Other Pay Grades
Diagnostic	100%	100%
Preventive*	100%	100%
Emergency Services	100%	100%
Sealants	80%	80%
Basic Restorative	80%	80%
Endodontic	70%	60%
Periodontic	70%	60%
Oral Surgery	70%	60%
Other Restorative	50%	50%
Implant Services	50%	50%
Prosthodontic	50%	50%
Orthodontic	50%	50%
General Anesthesia	60%	60%
Intravenous Sedation	50%	50%
Consultation/ Office Visit	80%	80%
Post Surgical Services	80%	80%
Miscellaneous Services (occlusal guard, athletic mouthguard, bleaching)	50%	50%

Space maintainers are fully covered for patients under age 19 when involving posterior teeth. They are covered at 80% for patients under age 19 when replacing anterior teeth only.

A complete listing of program policies and procedures is included in your updated TDP Dental Reference Guide. Additional updates and information will be communicated to you in future editions of the Connection, as well as the website.

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