Dental  Fee
Schedule
Effective as of
May 1, 2009
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May, 2009


To Participants Eligible for Dental Benefits

Re: Changes to Fee Schedule for Network/Participating Dentists

Dear Participant:

The Dental Plan provided by the UFCW Local 1776 and Participating Employers Health and Welfare Fund (“the Fund”) has been in its current form since August of 1992.  Under the Plan, as an eligible participant you have choices for your dental benefit:

(1) You may elect to participate in the Fund's dental network and choose to obtain services from one of the participating network dentists. This option provides you with the highest level of benefit and lowest out-of-pocket cost;

-OR-

(2) You may "opt-out" of the Fund's dental network and obtain services from a dentist of your own choosing. This option provides you with the most choice in the selection of your dentist and dental specialist.

Under either option, the dental plan provides a valuable benefit and helps meet the needs of Fund participants. In order to continue to provide the dental plan, we routinely review the plan and the needs of participants, the network of dentists and dental specialists, and the Fund. A committee of qualified professionals, including the Fund’s Dental Consultant, the Fund’s Actuary and Fund Administrative staff was assembled to conduct that review. After a thorough analysis of the current dental fee schedule, dental plan design, and plan eligibility, the committee recommended certain increases to the fee schedule for network dentists. The committee’s recommendations and underlying data were thoroughly reviewed by the Board of Trustees.

The Trustees noted the importance of maintaining the dental plan with a network of a sufficient number of dentists to service Fund participants. At the same time, the Trustees had, as a primary concern, limiting, to the extent possible, increased costs to participants and the Fund. After much deliberation and work to balance these competing interests, the Trustees approved increases to the
dental fee schedule, which increases are necessary to continued operation of the dental plan. These changes, which are effective as of May 1, 2009, are detailed in the attached Dental Fee Schedule. The procedure codes which have been increased are shown in red and bold faced type. Please keep this revised Dental Fee Schedule with your Summary Plan Description (“SPD”) for future reference.

The Trustees recognize the importance of good dental health to the overall health of Fund participants, and strive to maintain a plan of dental benefits to satisfy these important needs. If you have any questions regarding these dental fee increases, or if you have a question about the dental plan, please contact the Fund office at
(610) 941-9400 or toll free at 1-800-458-8618 or by e-mail at fund@ufcw1776benefitfunds.org.

Very truly yours,

Regina C. Reardon
Regina C. Reardon
Fund Administration