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Kaiser Permanente Insurance Company - …

Dear Insured: Thank you for choosing Kaiser Permanente Insurance Company 's (KPIC) Dental Assistance Insurance Plan. Enclosed is your new Certificate of Insurance (COI) and Table of Allowances. It supersedes and replaces any Certificate of Insurance and Table of Allowances that KPIC may have previously issued to you for this coverage. Please note that this new COI now reflects the name of the new Dental Trust, UMB Bank. KPIC's Administrator for the Dental Assistance Insurance Plan is Delta Dental of California. For questions, please call the following phone numbers: Questions Regarding Phone Number Claims or Benefits (888) 335-8227. Eligibility, Enrollment or cost (800) 464-4000.

GC-DENT-FP-CA (2002) FED (2006) KAISER PERMANENTE INSURANCE COMPANY One Kaiser Plaza Oakland, California 94612 GROUP DENTAL CERTIFICATE This is your Certificate of Insurance (hereinafter Certificate) while You are insured.

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