Renewal of Group Dental Contract
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REVISED
J nuuary 6, 2009
Ms. KrystaI Noms
City of Salina
300 W Ash, Room 206
Salina, KS 67:402-0736
RE: Renewal of Group Dental Contract
Group #90396
Dear Ms. Norris:
Your contract with Delta Dental of Kansas will renew on February 1, 2009. We are pleased to be able to serve you
and your employees again and are committed to our continued partnership with you.
Because Delta Dental mal,es every effort to hold increasing dental costs to a minimum, your administrative rate for
February 1, 2009 experienced an increase. Effective with your February 1, 2009 renewal, the administrative l'llte for
your dental coverage will change to $3.40 per subscriber per month. In addition, we would like to offer dle following
one or dlree year rate cap options:
Current
Rates
Admin Rate: $3.25
NOTE: Change Renewai Date to February 1, 2009
New
Rates
$3.40
Option 1-1 YR
Admin Rate:
New
Rates Option II - 2 YR
$3.25 - 2009 - No Increase
$3.40 - 2010
2 year agreement: Pass for 2009 and $3.40 for 2010
Change Renewal Date to February 1, 2009
Current
Rates
$3.25
*NOTE:
Admin Rates:
New
Rates Option III - 3 YR
$3.25 - 2009 - No Increase
$3.40 - 2010
$3.55 - 2011
**NOTE: 3 year agreement: Pass for 2009 and $3.40 for 2010 and $3.55 for 2011.
Change Renewal Date to February 1, 2009
Current
Rates
$3.25
Enclosed is a policy endorsement to indicate your acceptance of your option for this renewal. Please sign and return
one of the endorsements in the enclosed self-addressed envelope, or fll.-,,{ to (316) 462-3329. Thisl endorsement must
be returned by January 8. 2009 to ensure timely submission ofyow group's renewal.
DELTA DENTAL OF KANSAS
r619 N. Waterfront Park-way
P.O. Box 789769
Wichita, KS 67278'9769
Main Telephone; 3,6,264-1099
Customer Service; 316'264'45rI
Marketing & Sales: 3 [6'264:84l3
Eligibility & Enrollment: 316';1.64'45fI
800'733-5823
800'234'3375
800.264-9462
800'234'3J75
Fax; 316-462-3393
Fax; 3r6-,ph-3393
Fax; 316.,~6:.l'3329
Fax: 3I6-462'3394
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We look forward to the continued opportunity to be of seLinceJo you and your employees. If you have any questions
regarding your renewal, please feel free to contact your agent or me.
Sincerely,
~ fJlcdu& !1r ~
Amy Natalie
Account Executive
AN/kam
Enclosures
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REVISED: January 6, 2009
RENEWAL CONFIRMATION NO.1
FOR GROUP"#90396
Attached to and forming a part of the Agreement To Provide Dental Care Benefits between
City of Salina (plan #90396) and Delta Dental of Kansas, Inc. .
It is agreed and understood that effective with the February 1,2009, renewal, Section I, Number 6 shall
read:
RATE: Admin Rate: $3.40
NOTE: Change Renewal Date to Febmary 1, 2009
OP'TION I -1 YR
OPTION 11- 2 YR
RATE: Admin Rate: $3.25 -No Increase
*NOTE: 2 year agreement: Pass for 2009 and $3.40 for 2010
Change Renewa~ Date to Febmary 1, 2009
OPTION 111-3 YR
RA IE: Admin Rate: $3.25 - No Increa<se
**NOTE: 3 year agreement: Pass for 2009 and $3.40 for 2010 and $3.55 for 2011.
Change Renewal Date to Febmary 1, 2009
D
~
D
Please acknowledge acceptance of your option for this renewal by signing below and returning one copy
of the renewal confirmation in the enclosed, self-addressed envelope or fax to 316-462-3329 by
January 8, 2009.
~~OM 11-. &'tj-L
Printed Name
pC)- !rYl
Dat L
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Sjinature .
Agent's Name
~::t. ~X ~ru7?tt'^-'
Delta Dental of Kansas, Inc.