Dental: Benefits Summary / Program Highlights / Savings / Why Discount Dental? / How to Use / Enroll Plan Cost Single Group Rate - payroll deducted $9.00 per month Family Group Rate - payroll deducted $12.00 per month *No monthly billing available without payroll deduction. Single Individual Rate - home billing $108.00 Family Individual Rate - home billing $144.00

THIS IS NOT INSURANCE.
Payment must be made at the time of service in order to receive a discount.

Disclosures:
This plan is not a health insurance policy.
This plan provides discounts at certain health care providers for medical services.
This plan does not make payments directly to the providers of medical services.
The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who
have contracted with the discount plan organization.
This discount card program contains a 30 day cancellation period.
Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days.
The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received.
Discount Medical Plan Organization New Benefits, Ltd. 14240 Proton Road Dallas, TX 75244