ANSWERS TO COMMONLY ASKED QUESTIONS

WHO IS OHS ?
OHS is a CompBenefits company, a leader in the development and administration of dental and vision plan benefits. Founded in 1978, CompBenefits has systematically grown its operations to meet customer needs, expectations and market potential, servicing over 4.5 million members in the South and Midwest.

HOW DO I SELECT A DENTIST ?
OHS contracts with established dentists in the community to provide quality care to our members. To receive benefits, simply seek treatment from any dentist listed in the OHS Dental Provider Directory. Each family member has the option of selecting different dental offices. Dentists undergo a thorough review process prior to acceptance into our network.

WHAT IF I WANT TO CHANGE DENTISTS ?
As long as you seek treatment from a participating dentist, benefits will be paid for covered procedures. There is no requirement to pre-select a dentist.

WHAT DO I DO IF I NEED SPECIALIST CARE ?
Certain dental procedures will require the services of a specialist (i.e. some oral surgery, endodontics, and periodontics). In those cases, you may select a participating specialist and you will be charged the specialist's appropriate co-payment from our Benefit Schedule.

WHO IS RESPONSIBLE FOR FILING DENTAL CLAIMS WITH OHS ?
For in-network care, claim filing is the responsibility of the network dentist and specialist. Members will only be charged the co-payment as outlined in the Schedule of Benefits for specific procedures. Members seeking services from an out-of- network dentist will be reimbursed by OHS according to The Benefit Schedule. Depending on the out- of -network dentist's policy, you may be required to file your claim for reimbursement. You will receive timely payment directly from OHS.

WHAT IF I HAVE A DENTAL EMERGENCY WHEN I AM OUT OF THE NETWORK AREA ?
Emergency benefits are provided for immediate relief of pain only. All follow-up treatment and necessary dental work must be provided by the member's participating network dentist.

HOW DO I MAKE AN APPOINTMENT WITH MY DENTIST ?
You may schedule appointments by calling any dental office listed in the Provider Directory after your effective date of coverage. When calling to schedule an appointment, notify the office that you are an OHS member.

AM I RESPONSIBLE FOR THE OFFICE VISIT CO-PAYMENT IF I GO OUT-OF-NETWORK?
Yes. The office visit co-payment applies to all preventive and diagnostic services both in and out-of-network.

ARE MY DEPENDENTS ELIGIBLE ?
Eligible dependents include your legal spouse and unmarried children up to age 19 or 26, if a full- time student. Coverage is extended to any de-pendent incapable of self-support by reason of mental or physical handicap and is primarily dependent on you for support. Proof of such incapacity and dependency shall be submitted to OHS within (31) days of the dependent's attainment of 19 years of age. Additional proof of such incapacity may be periodically requested by OHS.

ARE PRE- EXISTING CONDITIONS COVERED ?
All pre-existing conditions are covered under the Dental Access PPO except for dentures, bridges, and congenital malformations.

WHEN IS MY DENTAL PLAN EFFECTIVE ?
The effective date of coverage is established between your employer and OHS. Upon enrollment you will be notified of your effective date of cover-age. Enrollment in the dental plan is for a minimum of twelve (12) consecutive months while employed by your current employer. Enrollment in the dental plan will be allowed during open enrollment periods as determined by your employer and OHS.

WHO DO I CALL IF I HAVE A QUESTION ?
OHS is responsible for all administrative functions of the program. If you have an inquiry or grievance, OHS encourages you to submit it in writing to:

CompBenefits Corp.
1951 Bishop Lane, Suite #100
Louisville, KY 40218

Or call our Member Support Department, Monday through Friday, 8:00 a.m. to 5:00 p.m. EST Toll free (800) 342- 5209.

HOW DO I RENEW MY COVERAGE ?
Your coverage will automatically be renewed each year unless you notify your employer to terminate your coverage.

WILL THIS PLAN COORDINATE WITH OTHER DENTAL COVERAGE ?
Yes, we do offer coordination of benefits, but it is not intended for payments made for services rendered to members to exceed 100% of the cost of the service provided.

DO I HAVE TO ENROLL IN A MEDICAL PLAN TO GET DENTAL BENEFITS ?
Each employer makes unique decision concerning their employee benefits plans. You should contact your benefits administrator regarding the policy for your company.

WHEN MAY I CANCEL COVERAGE ?
Coverage can be cancelled at the next open enrollment. The OHS plan is an annual plan and member (s) may not cancel during the contract year.

IF I DO NOT ENROLL NOW, WILL I HAVE A CHANCE TO RECEIVE DENTAL BENEFITS IN THE FUTURE ?
Yes, at the next open enrollment period.

DO I RECEIVE IDENTIFICATION CARDS FROM OHS ?
Yes, the subscriber as well as all enrolled dependents will receive a dental identification card from OHS after enrollment.

CAN I ADD FAMILY MEMBERS DURING THE CONTRACT YEAR ?
Members can be added or terminated if change is due to a qualifying event (i.e. marriage, divorce, birth, adoption, etc.)

HOW DOES THE ORTHODONTIC DISCOUNT PLAN WORK?
Participating network orthodontists have agreed to offer a discounted fee to OHS members for a 24- month routine treatment plan. The maximum fee amount listed in the Orthodontic Discount Schedule of Benefits constitutes the total out -of- pocket expense per patient for covered services