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Better Business Bu rea u Central Indiana N Delaware Street Indianapolis, IN 46204· RE; Consumer Name - [redacted] Delta Dental Plan of Michigan, Inc ("DDMI''), NAIC #***, is in receipt of your letter dated November l, 2016, regarding a complaint against Delta Dental Plan of Indiana Inc("DDlN''J, NAIC #***DDIVll is the claims administrator for ODINUpon receipt, our Customer Service department promptly researched your inquiry [redacted] receives dental benefit cove rage under a fully-insured dental p1'ogra m sponsored by her employer, [redacted] (th e "Group"), The G rou p determines the level of dental benefits that are available to beneficiaries under the plan, Ms, [redacted] has expressed her concerns regarding the denial of several claims concerning her son, [redacted] 's, orthod ontic trea tment beginning in 2015, as well as a panoramic radiograph she received on 8/17/Upon review of the claims in question it has been determ ined that the claims were p rocessed accord I ng to the Group's Plan and the determinations will stand I n August of 2015, Ms [redacted] and her son were eligible und er sub·grouµ [redacted] th e Premium OptionHowever, effective January of 2016, Ms, [redacted] changed her coverage and she a nd her son became eligible under sub-group [redacted] the Intermediate OptionAttached is the Summa ry of Dental Plan Benefits for both PlansPlease note that the Premium Option has no age limit for orthodontic services, while the Intermediate Option has an age limitation of up to age When [redacted] began his orthodontic treatment in August of 2015, he was years old and eligible under the Premium OptionOn 12/13/ [redacted] turned years oldEffective 1/1/2016, Ms [redacted] switched coverage to the Intermediate Option with the orthodontic

Revdex.com of Central Indiana NDelaware Street, #Indianapolis, IN Re: Case Number: *** Complainant: *** *** Delta Dental Plan of Michigan, Inc(“DDMI”) is in receipt of your letter dated 1/1/directed to Delta
Dental Plan of Indiana, Inc(“DDIN”)DDMI is the claims administrator for DDIN In Ms***s complaint she expresses her concern with regard to DDIN’s use of member social security numbers as an identification numberPursuant to MCL 445.83(3)(a)(vi), it is not a violation to use all or more than four sequential digits of a social security number when used by an administrator in the ordinary course of business to provide or administer employee or health insurance or membership benefits or claimsAdditionally, DDMI does not publish or print member social security numbers on policies, summaries or certificatesMember social security numbers are used for identification purposes only Delta Dental Plan of Michigan, Inc(“DDMI”) is in receipt of your follletter dated September 25, concerning the use of member social security numbersAn identification card is not necessary when making an appointment or seeking treatment from a dental providerA dentist can verify a member’s eligibility information hours a day, days a week, by accessing DDMI’s online Dental Office Toolkit (https://www.toolkitsonline.com)However, if a member would like to print an identification card for reference purposes, the Consumer Toolkit (https://www.toolkitsonline.com) allows a member to print an identification card for the subscriber that can be used for all eligible dependentsIdentification cards will only print in the subscriber’s name and for security purposes, the member’s social security number will not print on the card. From the attached sample identification card, please note that the group/client name and number are also printed on the identification card If you have any further questions, please contact meThank youSincerely, Walter LB*** Deputy General Counsel

Better Business Bu rea u Central Indiana 151 N . Delaware Street 112020 Indianapolis, IN 46204·2599   RE;       Consumer Name - [redacted] Delta Dental Plan of Michigan, Inc ("DDMI''), NAIC #[redacted], is in receipt of your letter dated November l, 2016, regarding...

a complaint against Delta Dental Plan of Indiana Inc.. ("DDlN''J, NAIC #[redacted]. DDIVll is the claims administrator for ODIN. Upon receipt, our Customer Service department promptly researched your inquiry.   [redacted] receives dental benefit cove rage under a fully-insured dental p1'ogra m sponsored by her employer, .[redacted] (th e "Group"), The G rou p determines the level of dental benefits that are available to beneficiaries under the plan,   Ms, [redacted] has expressed her concerns regarding the denial of several claims concerning her son, [redacted]'s, orthod ontic trea tment beginning in 2015, as well as a panoramic radiograph she received on 8/17/2016. Upon review of the claims in question it has been determ ined that the claims were p rocessed accord I ng to the Group's Plan and the determinations will stand.   I n August of 2015, Ms. [redacted] and her son were eligible und er sub·grouµ [redacted] th e Premium Option. However, effective January of 2016, Ms, [redacted] changed her coverage and she a nd her son became eligible under sub-group [redacted] the Intermediate Option. Attached is the Summa ry of Dental Plan Benefits for both Plans. Please note that the Premium Option has no age limit for orthodontic services, while the Intermediate Option has an age limitation of up to age 19. When [redacted] began his orthodontic treatment in August of 2015, he was 18 years old and eligible under the Premium Option. On 12/13/2015.. [redacted] turned 19 years old. Effective 1/1/2016,  Ms. [redacted] switched coverage to the Intermediate Option with the orthodontic <ige limitation. Therefore, the claims for [redacted]'s orthodontic treatment after he turned 19 were properly processed and denied in accordance with the Group's Plan Under Ms. [redacted]'s current Group Plan, the Intermediate Plan, there is a $1,000 per person total, per lifetime limitation on orthodontic services. TO date, [redacted] has utilized a total of $878.60 towards this limitation   Finally, pursuant to the Group's Plan, panoramic radiographs are pay8ble once I n any five-year period. Ms. [redacted] had a panoramic radiograph on 7/30/2013 and aga I n on 8/17/2016. Therefore, the claim was properly processed and the rdiograph wa s denied due to the five year frequency l im ita tion in the Group's Pla n.   We be lieve t h is letter adequately add resses Ms, [redacted]'s concerns. If you have a ny qu estions or concerns, please feel free tc contact me at (517) 347-5295 or by email at [email protected]. Walter L. B[redacted] Deputy Genera l Counsel **see more attache documents