Small Group Dental Rates 2nd Quarter 2010

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1 Rates for Unloaded Industries* Option 2: DE Preventive Care PPO Max 2 to 9 $17.60 $34.60 $34.40 $ to 25 $15.80 $31.60 $31.30 $ to 50 $15.10 $29.90 $29.70 $44.90 Option 3: DE Preventive Care PPO 2 to 9 $20.90 $41.10 $40.90 $ to 25 $19.20 $37.40 $37.10 $ to 50 $18.40 $35.70 $35.50 $53.50 Option 4: DE PPO Max to 9 $28.90 $58.10 $56.80 $ to 25 $26.60 $53.20 $52.00 $ to 50 $25.40 $50.50 $49.40 $74.50 Option 5: DE Active PPO, High Option 2 to 9 $37.40 $75.50 $76.80 $ to 25 $34.30 $68.90 $77.40 $ to 50 $32.70 $65.50 $73.70 $ * If the group s SIC code does not appear on the list of Loaded Industries or Ineligible Industries, these rates apply. Option 6: DE PPO to 9 $40.90 $82.00 $81.10 $ to 25 $37.10 $74.80 $81.80 $ to 50 $35.50 $71.20 $77.70 $ Option 7: DE PPO 1500 (90th) 2 to 9 $41.40 $83.10 $82.20 $ to 25 $37.70 $75.90 $83.00 $ to 50 $35.90 $72.30 $78.90 $114.90

2 Rates for Unloaded Industries* Voluntary Option 2: DE Preventive Care PPO Max 3 to 9 $19.40 $38.00 $37.60 $ to 25 $17.70 $34.80 $34.50 $ to 50 $16.60 $33.20 $32.90 $49.40 Voluntary Option 3: DE Preventive Care PPO 3 to 9 $22.90 $45.10 $44.90 $ to 25 $21.00 $41.30 $41.10 $ to 50 $20.00 $39.40 $39.20 $58.80 Voluntary Option 4: DE PPO Max to 9 $31.30 $62.90 $61.50 $ to 25 $28.50 $57.30 $56.10 $ to 50 $27.30 $54.80 $53.50 $80.50 * If the group s SIC code does not appear on the list of Loaded Industries or Ineligible Industries, these rates apply.

3 Rates for Loaded Industries* Option 2: DE Preventive Care PPO Max 2 to 9 $19.40 $38.10 $37.80 $ to 25 $17.40 $34.80 $34.40 $ to 50 $16.60 $32.90 $32.70 $49.40 Option 3: DE Preventive Care PPO 2 to 9 $23.00 $45.20 $45.00 $ to 25 $21.10 $41.10 $40.80 $ to 50 $20.20 $39.30 $39.10 $58.90 Option 4: DE PPO Max to 9 $31.80 $63.90 $62.50 $ to 25 $29.30 $58.50 $57.20 $ to 50 $27.90 $55.60 $54.30 $82.00 Option 5: DE Active PPO, High Option 2 to 9 $41.10 $83.10 $84.50 $ to 25 $37.70 $75.80 $85.10 $ to 50 $36.00 $72.10 $81.10 $ * If the group s SIC code appears on the list of Loaded Industries, these rates apply. If the group s SIC appears on the list of Ineligible Industries and the group is offering an Aetna medical plan, these rates apply. Option 6: DE PPO to 9 $45.00 $90.20 $89.20 $ to 25 $40.80 $82.30 $90.00 $ to 50 $39.10 $78.30 $85.50 $ Option 7: DE PPO 1500 (90th) 2 to 9 $45.50 $91.40 $90.40 $ to 25 $41.50 $83.50 $91.30 $ to 50 $39.50 $79.50 $86.80 $126.40

4 Rates for Loaded Industries* Voluntary Option 2: DE Preventive Care PPO Max 3 to 9 $21.30 $41.80 $41.40 $ to 25 $19.50 $38.30 $38.00 $ to 50 $18.30 $36.50 $36.20 $54.30 Voluntary Option 3: DE Preventive Care PPO 3 to 9 $25.20 $49.60 $49.40 $ to 25 $23.10 $45.40 $45.20 $ to 50 $22.00 $43.30 $43.10 $64.70 Voluntary Option 4: DE PPO Max to 9 $34.40 $69.20 $67.70 $ to 25 $31.40 $63.00 $61.70 $ to 50 $30.00 $60.30 $58.90 $88.60 * If the group s SIC code appears on the list of Loaded Industries, these rates apply. If the group s SIC appears on the list of Ineligible Industries and the group is offering an Aetna medical plan, these rates apply.

5 SIC Codes for Ineligible Industries* SIC Range SIC Description 7933 Bowling Centers 8611 Business Associations 7911 Dance Studios, Schools Employment Agencies 7999 Misc Amusement and Recreation 8699 Misc Membership Organizations 8999 Misc Services 7991 Physical Fitness Facilities 8811 Private Households Professional Sports Clubs & Producers, Race Tracks Professional Membership Organizations, Labor Unions, Civic Social & Fraternal Organizations, Political Organizations Public Golf Courses, Amusements, Membership Sports & Recreation Clubs 8661 Religious Organizations Theatrical Producers, Bands, Orchestras, Actors * If the group s SIC code appears above and the group offers Aetna medical, the dental rates for Loaded Industries apply. If the group s SIC code appears above and the group does not offer Aetna medical, the group is not eligible for Aetna dental products.

6 SIC Codes for Loaded Industries* SIC Range SIC Description 7319 Advertising, Misc Amusement, Recreation & Entertainment Associations & Trusts Auto Dealerships Beauty & Barber Shops Direct Mailing, Secretarial Services Engineering & Mgmt Services Hotels 9721 International Affairs Jewelry Manufacturing Legal Medical Groups 7389 Misc Business Services 7379 Misc Computer Services Misc Repair 5271 Mobile Home Dealers Passenger Transportation 7221 Photo Studios 7384 Photofinishing Labs Real Estate Repairs, Cleaning, Personal Services Restaurants Schools, Libraries, Education Seasonal Employees Security Systems, Armored Cars Private Households Social Services; Museums, Art Galleries, Botanical Gardens 7631 Watch, Clock & Jewelry Repair * If the group s SIC code appears at left, dental rates for Loaded Industries apply to the group.

Small Group Dental Rates First Quarter 2011

Small Group Dental Rates First Quarter 2011 Rates for Unloaded Industries* Option 2: DMO Access 2 to 9 $19.30 $35.90 $36.30 $53.10 10 to 25 $17.60 $32.80 $36.20 $51.60 26 to 50 $16.70 $31.30 $34.60 $49.20 Option 3: Freedom-of-Choice 2 to 9 $29.50

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