Physician Contracting Group of Texas

Rates effective: 1/1/09 for an effective date no later than 6/30/09

• Case size is based on number of employees enrolling.
• Please contact your sales representative for group 100+.

Preventive Plus

• $50 individual calendar-year deductible
• Deductible waived on preventive services
• Preventive services covered 100%
• Major services offer a discount with participating dentists
• $1,000 annual maximum
• Maximum allowable fee
• Some basic services covered at 50% after deductible

Traditional Plus

• $50 individual calendar-year deductible
• Deductible waived on preventive services
• Orthodontia discount
• Preventive services covered 100%
• Major services covered at 50%
• $1,000 annual maximum
• Maximum allowable fee
• Perodontics and Endodontics covered
• Basic services covered at 80%

	Employer-sponsored	Voluntary
Product	Case Size: 2-99	Case Size: 2-99
Preventive Plus
Employee	$12.09	$12.99
Employee & spouse	$26.58	$28.63
Employee & child(ren)	$30.15	$32.56
Family	$47.02	$50.82
Traditional Plus
Employee	$27.26	$30.42
Employee & spouse	$61.31	$68.51
Employee & child(ren)	$52.57	$58.64
Family	$87.59	$97.83
Insured or administered by Denticare, Inc. (d/b/a Compbenefits)